Eli's Hospice Insider
Master Tricky Drug Reporting On Hospice Claims With This MAC's Tips
Medication reporting errors mess up hospice claims processing.
Starting back in April, Medicare has required mandatory drug reporting on hospice claims. But that requirement has been delaying hospices’ claims when they don’t report drugs correctly. Use the following pointers from CGS to avoid the cash flow crunch.
Don’t use S codes: “HCPCS that begin with an ‘S’ (ex. S5502) are private payer codes, and are not valid for Medicare use,” the Medicare Administrative Contractor says on its website. “These HCPCS should not be reported on Medicare claims unless a valid HCPCS is determined.”
Don’t list these codes: “HCPCS for saline solutions and dextrose should not be reported,” CGS instructs. “These codes include, but are not limited to, J7030, J7040, J7042, J7050, and J7060.”
Do use a valid revenue code: “HCPCS codes for drugs should only be reported with a 0636 revenue code (Injectable drug) or 0294 revenue code (Drug administered via infusion pump),” CGS says on its website. Plus, “revenue code 0250 is to report non-injectable drugs, and should only be reported with a National Drug Code (NDC), not a HCPCS code,” the MAC adds.
More information and links to drug reporting resources are at http://cgsmedicare.com/hhh/pubs/news/2014/1114/cope27591.html.
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