If a hospice fails to recertify the patient should the agency discharge the patient or use span code 77?

Answer:

If a hospice fails to obtain the recertification within the specified time (within two days of the date the recertification is due), then the hospice would submit the claim using Occurrence Span Code 77 and the dates would be from the date the certification was due through the date the patient was actually discharged.

If the reason recertification was not obtained is due to a missed face-to-face, the use of occurrence span code 77 is not permissible. If the required face-to-face encounter is not timely, the hospice would be unable to recertify the patient as being terminally ill, and the patient would cease to be eligible for the Medicare hospice benefit. In such instances, the hospice must discharge the patient from the Medicare hospice benefit because he or she is not considered terminally ill for Medicare purposes.

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