Medicare Hospice Claims with KX Modifier and Hospice Non-covered Days due to Late Notice of Election

Hospice agencies reporting Non-covered days/units with Condition Code 77 due to late Notice of Election and utilizing the KX Modifier to file for an exception will see their billing claim files Returned to Provider (RTP).  Medicare is requiring the Non-covered days and total dollar amounts reported to also include the total number of non-covered units.  All covered charges will include the total number of units and dollar amounts.  These will be reported on separate lines with in the electronic ANSI 837 claim file.  However with in the ANSI 5010 Standards for 837 files, there is only one place to report total units.  The software will include the total number of Covered units in the electronic file.  Due to the ANSI 5010 Standards for 837 files, Allegheny Software is unable to make a software change to the 837 file to report the Non-covered units, nor will Medicare accept an 837 claim file modified to include these non-covered units.  Agencies will need to manually enter the Non-covered units with in the FISS System upon receipt of the Return to Provider (RTP).

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