Please Note: There is no Medicare information on our corporate website. Please select a specific contract in the 'Search Within' box for Medicare related information.
© 2019 Palmetto GBA, LLC
We frequently update our articles to reflect the latest changes and updates to Medicare, and strongly recommend you visit this article at link below to confirm you have the latest version.
Printed Date: 9/22/2015
The referring physician and attending physician cannot be the same. If they are then the referring physician information should not be reported.
Explanation and Suggestion
Change Request (CR) 7755 was implemented on October 1, 2012, and requires hospice agencies to report the certifying physician information in the Referring Physician field on a claim when different than the attending physician. If the attending and certifying physician is the same, or the patient does not have an attending physician, only report the certifying physician’s NPI in the ATT PHYS field.
Your claim will go to the Return to Provider (RTP) file if the same NPI is entered into both the ATT PHYS and REF PHYS fields. If the attending and certifying physician is the same, or the patient does not have an attending physician, only report the certifying physician’s NPI in the ATT PHYS field.
For hospice providers who submit electronic claims via the 837I version 5010A2, the certifying physician information should be reported in the 2310F loop of the claim.
We value your opinion and want to provide the highest-quality and most relevant Medicare knowledge possible. Please let us know if this article was helpful.
It didn't answer my question
This article was helpful
We’re glad we could help you today and appreciate your feedback. When you rate our articles as most helpful, we know that we are on the right track for providing you with important news and information.
We're sorry this article didn't help you today. We'll use your feedback to review this article to try to revise or expand it. Contact us with more feedback or a question on this topic.
Last Updated: 01/11/2018