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New Requirement for Hospice Claims


Hospice agencies are required to report the physician that certified the hospice patient’s terminal illness on the claim when the certifying physician differs from the attending physician. The certifying physician is reported on the UB04 claim in the “Other Physician” field. With the implementation of the electronic claim 837I version 5010A2 format, the field for “other physician” is mapped to three possible physician identifying fields. Hospice agencies reporting the physician certifying the terminal illness using the electronic claim 837I version 5010A2 format should report this information in the 2310F loop of that claim.

Reference: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM7755.pdf

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