Tip: Include weekly breakdowns on monthly claims.
You have only a few months to master changes to hospice claim requirements for 2008. Check out these commonly asked questions--and additional resources--to get a running head start: • Medicare has always paid for hospice services on a per diem basis. Will this change with the weekly reporting of services required by Change Request 5567? No, says CMS in its recently issued "questions and answers" document on CR 5567 (available at
www.cms.hhs.gov/center/hospice.asp). The additional lines on hospice claims reporting visits per week do not affect payment but are for data collection purposes only, the agency instructs. • Will hospices continue to bill on a monthly basis? Yes. To comply with the new weekly visits reporting requirement, report partial weeks as necessary to stay within a given month, CMS advises in its Q&A. For example, if the first three days in a week fall in one month and the last four in the next month, report a line for that week on the claim for the month that is ending, but report only services on the days that fall in that month. To complete reporting for the week, include a line for the week on the next month's claims, to report services that fall in the beginning of that month.
• What if you make a mistake in recording the number of visits in a given week? "Make your best effort to include all of the visit information at the time when the bill is originally submitted," coached a CMS official speaking at the Home Health Open Door Forum Aug. 29. If you discover a mistake later, submit an adjustment even though it doesn't directly affect payment, he added. Listen in: To find out more about the hospice claim changes, check out the Ask the Contractor Teleconference (ACT) held by Palmetto GBA on Oct. 22. For information, go to
www.palmettogba.com. To listen to the teleconference, call 1-877-718-5092 on Oct. 22 at 2 p.m. ET; request the 2008 Hospice Changes ACT call.
Coding tips: Medicare contractor Cahaba GBA has updated its tool, "Hospice Billing Codes Sheet," to reflect information from CR 5567. The tool is available at
www.cahabagba.com/part_a/education_and_outreach/educational_materials/hospice.htm.