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Printed Date: 9/22/2015
For claims with service from date 10/01/05 or greater, a value code 61 is present with a value amount that contains more than 5 positions (not including decimal places) that represent the CBSA code, but the CBSA code is either invalid or is not present on the CBSA table.
The claim is TOB 81x or 82x (not NOE) with revenue code 655 or 656 and from date on or after 01/01/08, a value code G8 is present with a CBSA code that is either invalid or not present on the CBSA table.
Explanation and Suggestion
The Core Based Statistical Area (CBSA) code must be present on all hospice claims. This code is a five-digit number, followed by a decimal point and two zeros. Example: XXXXX.00. Current wage index tables with CBSA codes are found on the CMS website. Notify software vendors if necessary.
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Last Updated: 01/11/2018