A new claims system glitch may be slowing down your hospice payments.
The problem: “Since the July 2023 System Release, Medicare has seen an increase in hospice claims editing for reason code (RC) W7048,” HHH Medicare Administrative Contractors Palmetto GBA and CGS both say in their Claims Payment Issues Logs. “This reason code states one or more visit revenue codes were reported on the claim without the required corresponding HCPCS code. RC W7048 has been firing incorrectly for revenue codes 0250 (non-injectable prescription drugs), 0290 and/or 0294 (infusion DME and drugs), which do not require HCPCS codes,” Palmetto and CGS explain.
Hospices will have to hang tight for a solution, however. “This issue has been identified and is currently in research,” Palmetto and CGS say.
More details about which revenue codes require HCPCS codes are at www.cgsmedicare.com/hhh/claims/fiss_claims_processing_issues.html.