Telehealth Home Health Services: New G-Codes

Telehealth Home Health Services: New G-Codes Prior to 1/1/2023, data on telecommunications technology used during a 30-day period of care at the patient level was not collected on HH claims. Effective 1/1/2023, HHAs may begin voluntarily [...]

Home Health Therapy Billing

Home Health Therapy Billing Table of Contents Home Health Therapy Billing 32X TOB: Billing Therapy Under a Home Health Plan of Care Discipline Revenue Codes (UB-04 FLs 42-43) Discipline HCPCS Codes (UB-04 FL 44) Service Units [...]

Overlapping Claim Tips for Resolution

Overlapping Claim Tips for Resolution Table of Contents Overlapping Claim Tips for Resolution Type of Bills Impacted Inpatient Hospital Overlap Tips Hospital Discharge Coding Hospital Overlapping with Home Health Care Hospital [...]

Medicare Beneficiary Identifier

The MBI is the patient identification number assigned to Medicare beneficiaries. Claims submitted to Medicare contractors must contain the MBI. In 2020, CMS removed the SSN based identifier from the Medicare card to protect beneficiaries and [...]

Exceptions

The official transition period for the new Medicare Number has ended. The MBI should be used for all of your transactions and inquires. CMS will continue to accept the HICN on the following data exchanges after 1/1/2020. These are the only [...]

Medicare Hospice Quick Reference Sheet

Medicare Hospice Quick Reference Sheet The codes listed below are only those most frequently applicable to hospice claims. For a complete list of codes, see the NUBC manual. The NUBC maintains the UB-04 data element specifications and revenue [...]

Professional Services During a Patient Hospice Election

Professional Services During a Patient Hospice Election Table of Contents Article Overview Hospice Election Medicare Payment During Hospice Election Determining the Correct Entity to Bill Separately Payable Part B Services [...]

Hospice Change of Ownership

Hospice Change of Ownership Table of Contents Hospice Change of Ownership What is Not a CHOW The Provider Enrollment Process Purchase Agreement Merger/Acquisition [Return to Top] Hospice Change of Ownership CHOW is defined [...]

Filing an Electronic Notice of Cancelation (Type of Bill 8XD)

Filing an Electronic Notice of Cancelation (Type of Bill 8XD) Table of Contents Filing an Electronic Notice of Cancelation (Type of Bill 8XD) Steps to Cancel a NOE Steps to Cancel a Benefit Period Submitting the 8XD Related Content [...]

Avoiding Reason Code 7C625: Appropriate Use of Remarks on Final Hospice Claims

Avoiding Reason Code 7C625: Appropriate Use of Remarks on Final Hospice Claims Once a hospice chooses to admit a Medicare beneficiary, it may not automatically or routinely discharge the beneficiary at its discretion, even if the care promises [...]

Canceling a Hospice Notice of Election

Canceling a Hospice Notice of Election When a patient elects hospice, the hospice submits a NOE to the MAC to notify the MAC and all other providers that the patient is now utilizing the Medicare hospice benefit for all services related to the [...]

Appropriate Use of Occurrence Code 27 and Occurrence Span Code 77

Appropriate Use of Occurrence Code 27 and Occurrence Span Code 77 Table of Contents Appropriate Use of Occurrence Code 27 and Occurrence Span Code 77 Example of the Proper Use of OC 27 Example of the Proper Use of OC 27 with OSC 77 [...]

Completing the Advance Beneficiary Notice for Home Health Agency Demand Claims

Completing the Advance Beneficiary Notice of Noncoverage for Home Health Agency Demand Claims The purpose of the ABN is to appropriately notify a Medicare beneficiary of services that the HHA believes Medicare will not cover. In order for the [...]

Home Health Billing When a New MBI is Assigned

Home Health Billing When a New MBI is Assigned A patient’s MBI number is required on all home health billing submitted to Medicare. CMS will issue a new MBI when an original MBI may have been, or has been compromised. There are times a home [...]

Hospice Billing Codes Chart

Hospice Billing Codes Chart Table of Contents Hospice Billing Codes Chart Condition Codes (CC) (UB-04 FL 18-28) Occurrence Codes (OC) and Dates (UB-04 FLs 31-34) Occurrence Span Code and Date (UB-04 FLs 35-36) Value Codes (VCs) and CBSA [...]

Hospice Room and Board Denials

Hospice Room and Board Denials Medicare does not pay the room and board fees for hospice beneficiaries that reside in a SNF or a nursing facility (NF), as these charges are statutorily excluded from Medicare coverage. However, these charges [...]

Education Partnership Request Form

Hospice Site of Service Codes

Hospice Site of Service Codes Table of Contents Hospice Site of Service Codes HCPCS Codes Site of Service Location Notes Edits Related Content [Return to Top] Hospice Site of Service Codes Hospice agencies must report an HCPCS [...]

Reporting Hospice Discharges, Revocations and Transfers

Reporting Hospice Discharges, Revocations and Transfers Medicare regulations at 42 CFR 418.26 outline three reasons for discharge from hospice care: The beneficiary moves out of the hospice’s service area or transfers to another [...]

Create an Account - Standard

Create an Account – Standard Table of Contents Create an Account – Standard Step 1 – Account Step 2 – Individual Step 3 – Business [Return to Top] Create an Account – Standard An NGSConnex Standard Account holder will [...]