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Technical Corrections to CR10064

Posted on Monday, October 2, 2017 12:25 PM

Accepting Hospice Notice of Election via EDI

On July 27, 2017 CMS released Change Request 10064. This Change Request allows for the submission of the Hospice Notice of Election via Electronic Data Interchange (EDI) and revises the Claims Processing Manual for hospice claims. Hospices are encouraged to review this Change Request.

However, in the original Transmittal (3813), there was an error in the table of hospice discharge reason codes (page 23). The original document incorrectly uses the phrase: ‘Condition Code’ versus ‘Occurrence Code’.

On September 26, CMS released Transmittal 3866 rescinding Transmittal 3813 due to this error. Both Transmittals refer to Change Request (CR 10064). This new Transmittal (3866) corrects the error.

This is the correct information:

Discharge Reason

 Coding Required in Addition to Patient Status Code

Beneficiary Moves Out of Service Area

 Condition Code 52

Beneficiary Transfers Hospices

Patient Status Code 50 or 51; no other indicator

Beneficiary No Longer Terminally Ill

No other indicator

Beneficiary Discharged for Cause

Condition code H2


Beneficiary Revokes

Occurrence code 42



Click on this link to view the Transmittal in its entirety.

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