Home Health & Hospice Week
Watch Out For This Hospice Denial Error
Take evasive action for this claims system glitch, or wait it out.
Hospices will finally see some relief on a claims denial error — if a software patch works next month.
Problem: “Some hospice claims are being Returned to Provider (RTP) with reason code 36188 in error,” HHH Medicare Administrative Contractor CGS notes on its website. “The Fiscal Intermediary Standard System (FISS) is inserting Value Code 78 and an amount on Hospice claims that contain the Service Facility National Provider Identifier (NPI), name and address in the 2310E Loop and segments. The FISS is returning the claims to the provider with reason code 36188.”
Solution: Back in January, the Centers for Medicare & Medicaid Services issued a transmittal to correct the issue. But the fix won’t be implemented until July.
Try this: “Until the system release is implemented and the issue is resolved, hospices can remove the Value Code 78 and amount from the claim and resubmit the claim through the Direct Data Entry (DDE) system,” CGS suggests.
Home Health & Hospice Week
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Watch Out For This Hospice Denial Error
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