My claim rejected and the reason code states that Im overlapping a hospice election period. How can I tell if a beneficiary has elected the Medicare hospice benefit?
If a patient has elected the Medicare hospice benefit, this information will be posted to their eligibility file. Providers can determine this by viewing Page 2 of ELGA, and Page 9 of ELGH. For more information on how to read these screens, please access the Checking Beneficiary Eligibility section of the FISS Reference Guide. While a patient has elected the hospice benefit, the hospice agency is responsible for providing all care related to the terminal diagnosis. Medicare will not reimburse services submitted by other providers that are related to the terminal diagnosis while the patient has elected hospice. Medicare will reimburse services that are unrelated to the terminal diagnosis. Providers must indicate the services as unrelated by using a condition code 07 in FL 18-28 on the UB-04 claim form. This field corresponds with the “COND CODES” fields found on FISS Page 01. For more information, please access Web page, Top Claim Submission Errors for Home Health Providers: Error C7010
