Reason Code 34952

Published 10/02/2020

Description
A service facility National Provider Identifier (NPI) was required on the claim, but was not reported. Hospice providers are required to report a service facility NPI when billing any of the following place of service HCPCS codes.
  • Q5003 — hospice care provided in nursing long term care facility (LTC) or non-skilled nursing facility (NF)
  • Q5004 — hospice care provided in skilled nursing facility (SNF)
  • Q5005 — hospice care provided in inpatient hospital
  • Q5006 — hospice care provided in inpatient hospice facility (when not the same as the billing hospice)
  • Q5007 — hospice care provided in long term care hospital (LTCH)
  • Q5008 — hospice care provided in inpatient psychiatric facility
Resolution
Before submitting your claim, check to see if any of the above HCPCS are present. If present:

Before submitting your claim, check to see if any of the above HCPCS are present. If present:

  • The NPI of the nursing facility, hospital, or inpatient facility where the patient received services is required. Enter the service facility NPI in:
    • Loop 2310E (when billing in the 5010 electronic claim format); or
    • SERV FAC NPI field in the Fiscal Intermediary Standard System (FISS) on Claim Page 03


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