Hello, everyone, and welcome to our Monday Minute.
Today I want to share with you an update to the Medicare Hospice Claims Processing Manual, where they have updated the specific guidance to include a new billing edit that was put in place to prevent transfers from occurring where there is a gap in days between the transferring hospice’s last day and the receiving hospice’s first day of care.
An example of this occurring might be a patient that lives in Pennsylvania and the patient is being moved to Florida. The patient’s going to take two or three days to get there, and you have the Pennsylvania hospice that is technically transferring the patient to the hospice in Florida. Pennsylvania billed their last day as the day the patient leaves Pennsylvania, and Florida doesn’t bill until the patient is there, in Florida, and a part of that hospice organization. The manuals will not allow those types of transfers to occur. The billing will reject if there is a gap in days. That technically should have always been the case, but evidently, there has been billing that has made it through the system without that technicality being complied with. The strong suggestion is any time there’s going to be a gap in days, the patient would need to be discharged and then a brand-new admission done once they have arrived at their destination.
They also cleaned up some language, where they now use it to say “another location,” so the patient is being moved to another location versus a “subunit” language that was being used, which is technically relevant to home health versus hospice. They did make it very clear that the same provider number cannot transfer a patient in hospice. So, if the 81C, which is the type of bill that is used in a receiving hospice situation that is receiving a patient after a transfer, has the exact same provider number as the hospice that has transferred the patient, that will reject as well.
Hopefully, this has provided some key information for the transferring of hospice patients. I will include in the content of this minute a link to the Change Request that updates the manuals. If you have any additional questions regarding hospice transfers, please don’t hesitate to reach out.
We thank you very much for participating today and hope to see you at a conference really soon. Please make sure you stay connected to your state and national homecare and hospice associations and continue to participate in all of the educational opportunities that they provide. Have a fabulous week.