CMS clarifies reporting requirements for hospice providers operating in skilled nursing facilities

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New revisions to the Medicare Claims Processing manual are intended to clarify requirements for hospice providers operating in skilled nursing facilities, the Centers for Medicare & Medicaid Services announced recently.

The Affordable Care Act granted CMS the authority to begin collecting additional data on hospice claims. These new line-item requirements were described in a July 2013 manual update, and hospice providers began providing the additional claims information on a voluntary basis as of Jan 1. The latest manual update, dated Jan. 31, provides what CMS termed “clarifying information and examples.”

Some of the revisions concern the use of injectable and non-injectable drugs, and infusion pumps. For example, revised material specifies that the hospice should provide the National Drug Code for each prescription drug within a comfort kit/pack. Hospices also should reflect the total charge for an infusion pump for the claim period, regardless of how the hospice was billed for the pump.

Hospice claims for general inpatient care provided in a skilled nursing facility require line-item reporting in 15-minute increments, according to another revision. The manual also now includes an example of how a nurse should properly utilize the post-mortem visit modifier.

The new requirements are scheduled to take effect for all claims with dates of service on or after April 1, 2014.

Click here to access the manual update.

CMS also recently announced it will extend audit protections related to the controversial “two-midnight” inpatient admissions rule.

Hospitals now will be subject to limited post-payment reviews through Sept. 30, 2014, while they transition to the new regulation, according to a post on the CMS website. The rule is meant to cut down on the use of observation status for hospital stays that stretch several days.

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