RESOLVED: System Issues with the Recent Redesign of Hospice Election/Revocation Information as Stated in MLN Article SE18007

Current Status
10/4/2018: With the October 2018 Quarterly Release, all fixes have been installed for the redesign system issues. Providers may now return the claims for processing.

Situation:
Recent improvements were implemented in the July 2018 system release. The redesign ensures that hospice election and revocation date information are separate from benefit period information, so the two types of information can be changed independently.

The following reason codes have been editing incorrectly on NOEs/claims since the release.

  • U5106 - The NOE RTP for U5106 (NOE to add new election period, but falls within a previously established period), but still created a new benefit period. This issue is only identified on NOEs submitted prior to the July 2018 system release, but returned after.
  • U5159 - The system is not allowing the use of the 27 occurrence code on a claim to create the new benefit period on claims.
  • U5173 - The 27 occurrence code is not creating a new period.
  • U5113 – The NOTR RTP for U5113 (NOTR to terminate the election period, but the election period has already been revoked), but posted the revocation date. 
  • U514A – The Notice of Change ( type of bill 8XC) RTP for U514A. The system is not allowing the 8XC to establish a change of provider on the existing benefit period in which the transfer took place.
  • U5181 –There are two issues with this reason code:
    • Claims that unnecessarily reported occurrence code 27 and date during an existing benefit period  RTP with U5181. As a workaround, hospices may remove the occurrence code 27/date and return the claim for processing.
    • On other claims, the system is not allowing the use of the 27 occurrence code (when necessary) on a claim to create the new benefit period.

Status:
10/4/2018:
With the October 2018 Quarterly Release, all fixes have been installed for the redesign system issues. Providers may now return the claims for processing.

8/28/2018: The reason codes U5106, U5159, U5173, U5113, U514A and U5181 continue to edit incorrectly on NOEs/claims as detailed above. Once we receive further information Palmetto GBA will provide updates in this article. No provider action is required. It is not necessary to call the Provider Contact Center (PCC).

7/24/2018: Added issue with reason code U514A, which is related to the Notice of Change, type of bill 8XC.

7/23/2018: Added issue with reason code U5113

7/13/2018: Correction Edit U5106 is not limited just to NOEs submitted prior to the July 2018 system release. NOEs submitted after the release have also edited for U5106.

7/12/2018: The issues are in research. As more information becomes available for any of the issues, we will provide updates in this article. No provider action is required. It is not necessary to call the Provider Contact Center (PCC).

Contact Palmetto GBA JM Part HHH Medicare

Email HHH

Contact a specific JM HHH department

Provider Contact Center: 855-696-0705

TDD: 866-830-3188

Other Palmetto GBA Sites

Palmetto GBA Home

DMEPOS Competitive Bidding Program

Jurisdiction J Part A MAC

Jurisdiction J Part B MAC

Jurisdiction M Part A MAC

Jurisdiction M Part B MAC

Jurisdiction M Home Health and Hospice MAC

MolDX

National Supplier Clearinghouse MAC

PDAC

RRB Specialty MAC Providers

RRB Specialty MAC Beneficiaries

Anonymous

 


spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer