If your hospice claims are getting torpedoed by occurrence claim span (OCS) errors, Medicare Administrative Contractor CGS is offering a helping hand.
Problem: “Providers that submit claims electronically, via the ANSI X12N version 5010, do not have a way to report noncovered units,” CGS explains on its new webpage dedicated to identifying and resolving 34923 errors. “As a result, FISS is incorrectly plugging covered units in the COV UNIT field, despite noncovered charges being re-ported.”
Solution: Providers experiencing errors for this reason may either submit the claim via Direct Data Entry (using FISS) to accurately report the units as noncovered,” CGS instructs. “Or if the claim is submitted electronically, it must be corrected from their Return to Provider (RTP) file once the reason code 34923 is applied.”
More potential causes and fixes for this error are online at http://cgsmedicare.com/hhh/education/materials/34923.html.