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Printed Date: 9/22/2015
Claims with an effective date (receipt) of October 1, 2012, or after are received with occurrence code 55 present and patient discharge status is not equal to 20 (expired), 40 (expired at home), 41 (expired in a medical facility), or 42 (expired-place unknown), or if patient discharge status is equal to 20 (expired), 40 (expired at home), 41 (expired in a medical facility), or 42 (expired-place unknown) and occurrence code 55 is not present.
Explanation and suggestion:
Change Request (CR) 7792 was implemented on October 1, 2012. This CR requires that hospice agencies report occurrence code 55 to report date of death. If a discharge status code of 40 (expired at home), 41 (expired in medical facility), or 42 (expired – place unknown) is present on a hospice claim, occurrence code 55 with date of death must also be present on the claim.
If occurrence code 55 and date is on the claim, please make sure an acceptable discharge status (as mentioned above) is also on the claim. Reminder: Hospices do not report discharge status code 20.
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Last Updated: 01/11/2018