32162

FISS Narrative
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.

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

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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

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Anonymous

 


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