Wednesday, August 7, 2013

Additional Data Reporting for Hospice Claims

CMS issued an additional data reporting requirement for hospice claims on July 26, 2013.  It states that Medicare hospices shall report line-item visit data for hospice staff providing general inpatient care (GIP) to hospice patients in skilled nursing facilities (site of services HCPCS code Q5004) or in hospitals (site of service HCPCS Q5005, Q5007, and Q5008).  This includes visits by hospice nurses, hospice aides, social workers, physical therapists, occupational therapist, and speech-language pathologists, on a line-item basis, with call and call length reported as is done for the home levels of care.  CMS is not changing existing GIP visit reporting requirements when the site of services is a hospice inpatient unit (site of services HCPCS code Q5006).  For all visit / call reporting, only report visits / calls by the paid hospice staff: do not report visits by non-hospice staff.

Hospice shall report the 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, when the site of service is not the billing hospice.  Hospice shall report injectable and non-injectable prescription drugs on their claims.  Both injectable and non-injectable prescription drugs should be reporting on claims on a line-item basis per fill.  They shall also report infusion pumps on a line-item basis for each pump order and each medical refill.

The Voluntary Reporting for this rule is January 1, 2014 with Mandatory Reporting Effective April 1, 2014.

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