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Medicare Administrative Contractor Spills Details On GIP Edits
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Be prepared for extra scrutiny of your hospice claims containing General Inpatient care. In Palmetto GBA’s October Hospice Coalition meeting, a participant inquired about “general inpatient (GIP) edits planned for later this year for GIP delivered in the hospital or hospice inpatient facility setting.”
Details: Hospice providers 81X (freestanding) and 82X (hospital based) will be grouped together, the HHH Medicare Administrative Contractor responds in a Frequently Asked Question set. Provider-specific edits will be set for Q5004, Q5005 and Q5006.
“Length of stay and utilization are the triggering criteria” for the edits, Palmetto reveals. Hospices that have inpatient facilities may get hit hardest by the effort. “Hospices with their own facilities will have higher reimbursement dollars than those without facilities,” the questioner pointed out.
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