Reason Code: 17729

Error Description:

Hospice: The hospice claim denied because the physician listed as the attending physician does not have an active Medicare enrollment or is not opted-out to certify hospice claims.

Avoiding/Correcting This Error

This edit is applied if the NPI and first four letters of the physician’s last name submitted on the claim in the Attending field do not match the physician’s NPI and first four letters of the physician’s last name on the PECOS file, or physician’s does not have an active enrollment on the reported Occurrence Code 27 date.

An adjustment should be submitted when an input error (i.e., incorrect NPI, incorrect name spelling) is being corrected or the physician’s PECOS record has been updated. Refer to the following article for detailed instructions: 17729 and 17730 Hospice Claim Edits for Certifying Physicians.