An Update on Inappropriately Returned Hospice Claims for Pumps
Palmetto and CGS have both implemented the override function and hospices may resubmit claims
NAHC’s Hospice Association of America (HAA) recently posted an update from CGS about hospice claims that include ambulatory infusion pumps and their anticipated schedule for addressing the issue. For more, please see NAHC Report, July 17, 2014). Since then, another Medicare Administrative Contractor (MAC) has issued a notice that it, too, is addressing the issue.
The following is a notice from Palmetto that recently was posted to its website:
PALMETTO: Jurisdiction 11 Home Health and Hospice
Correction to Inappropriately Returned Hospice Claims: Reason Codes W7061 and W7072
Effective April 1, 2014, hospices are required to report certain prescription drugs and durable medical equipment items (MLN Matters® Article MM8358). It was found that some hospice claims reporting these items were being returned to providers in error.