Provider Types Affected
Hospice providers may be experiencing difficulty getting claims processed which include charges for physician services submitted with revenue code 0657 and the appropriate Current Procedural Terminology (CPT) code. A number of claims are being Returned to the Provider (RTP) with reason code W7072.
Background
The claims processing system for hospice claims is not currently processing hospice claims submitted with revenue code 0657 regardless of whether or not the CPT code submitted is valid.
What You Need to Know
Providers experiencing difficulty with getting their claims processed may remove the physician charges from the claim and resubmit the claim in order to process all other charges on the claim. A system fix is scheduled to be implemented in the July Release. Once the system fix is completed, hospice providers may either submit a late charge bill (8X5 type of bill) for the physician charges or adjust the original claim and add the physician charges. Palmetto GBA will notify hospice providers by way of an article on the Web site as soon as the problem has been corrected.
The information provided in this article was current as of June 30, 2009. Any changes or new information superseding the information in this article will be posted on the Palmetto GBA Web site at www.PalmettoGBA.com/rhhi in articles and publications with publication dates after June 30, 2009.