Our Products can help your organization stay educated and compliant. Shop Now >


CMS To Address Problems With Hospice Reporting Of Anti-Cancer & Anti-Emetic Drugs On Claims

Posted on Wednesday, August 12, 2015 9:47 AM

Some hospices have had claims reporting anti-cancer and anti-emetic drugs returned to the provider (RTP) since the imposition of the requirement to report prescription drugs on hospice claims. CMS and the Medicare Administrative Contractors (MACs) have discovered that this is happening because the Common Working File (CWF) contains an edit that restricts the allowable types of bills on which certain anti-cancer and anti-emetic drugs may be submitted; hospice bills; under current processing rules, may not include these prescription medications. CMS is directing MACs to instruct hospices to remove or omit service lines for oral anti-cancer and anti-emetic drugs from claims so that they can process normally. This action should continue until January 1, 2016, when the edit correction should become effective. Once the edit correction is in place, hospices will be encouraged to submit claims adjustments for all claims that are within the timely filing period to restore the reporting of the oral anti-cancer and anti-emetic drugs so that CMS has accurate data on usage of these medications. Click here to see these instructions posted on the CMS website as Transmittal 1528/Change Request. Click here to read more from NAHC.

About Corridor

Corridor is a trusted home health and hospice consulting partner to agencies both large and small. We provide the most up-to-date comprehensive homecare industry educational resources and consulting available.

We specialize in delivering better revenue cycle management solutions, coding and documentation review services, regulatory compliance, and healthcare consulting.

For the most important industry updates and news that impacts home health and hospice, please make sure to sign up for our weekly newsletter to receive the latest up-to-date industry information direct to your inbox!

For additional information, please contact Corridor at 1-866-263-3795

Go Back