Hospices to Report Additional Claims Data

Posted On: January 7th, 2014

By Terry Miller, RN, COS-C
Regulatory Advisor, McKesson

Hospices to Report Additional Claims DataNew claims reporting requirements for hospice agencies become mandatory on April 1, 2014. However, hospice providers may begin to voluntarily comply with these requirements as early as January 1, 2014.

The greatest pain point for hospice agencies likely will be the new requirements for prescription drugs and infusion pumps. Hospices have to report a line-item list of the prescription medications provided to each patient. For each fill or refill, the pharmacy has to provide a National Drug Code (NDC) qualifier that’s put on the claim form. Prescription drugs include injectable and non-injectable drugs for terminal illness and related diagnoses, regardless of the level of care or the service site.

Other facets of CR 8358 that you and your hospice agency should be aware of:

  • General inpatient (GIP) calls and visits made by paid hospice staff need to be reported on claims with length of visit information (rounded to the nearest 15-minute increment) for nurses, aides, social workers and therapists who are employed by the hospice
  • For post-mortem visits on the calendar day of death, length of visit information (rounded to the nearest 15-minute increment) will be required for nurses, aides, social workers and therapists who are employed by the hospice, using a post-mortem (PM) modifier.
  • National Provider Identifier (NPI) of any nursing facility, hospital or hospice inpatient facility where the patient is receiving services — regardless of the level of care provided, should be provided when the site of service is not the billing hospice. This requirement is in place to reduce the incidence of billing for duplicative services.

McKesson Hospice™ has been updated for reporting of GIP, PM visits and NPI. McKesson hospice software customers also now can begin participating in the reporting of prescription drugs and infusion pumps for their patients.

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