Hospice Billing

Filing an Electronic Notice of Cancelation (Type of Bill 8XD)

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Filing an Electronic Notice of Cancelation (Type of Bill 8XD)

Although rare, there are times when an NOE must be canceled. A notice of cancelation (8XD) is submitted when one of the following situations occur:

  • When a hospice election is established out of order, the NOE must be canceled.
    • Example: The patient was with Hospice ABC from June through July. In October, the patient elects the hospice benefit with Hospice XYZ. Hospice XYZ checks the CWF and does not see a previous election. Therefore, they submit their hospice NOE for the admission in October. Later that month, Hospice ABC contacts Hospice XYZ to cancel their NOE so that Hospice ABC can submit their NOE and claims for the June through July services.
  • When the beneficiary will not be receiving services from the hospice, but the NOE has already been submitted and posted to the CWF.

Note: There may be times where the patient’s attending physician or primary diagnosis may change after the patient has elected the hospice benefit. If the patient’s attending physician NPI and/or primary diagnosis code submitted on the NOE was correct at the time the NOE was submitted, the NOE would not need to be canceled.

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Steps to Cancel a NOE

Before canceling the NOE, the provider must cancel all processed claims (bill types 8X1, 8X2, 8X3, 8X4) within the election. Once all claims are canceled, submit the notice of void/cancel (TOB 8XD) to remove the notice of election (TOB 8XA).

Do not submit TOB 8X8 or 8XB to remove the notice of election as these TOBs will not remove the election period from CWF.

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Steps to Cancel a Benefit Period

In addition to canceling the NOE and your claims, you may also need to submit an 8XD to remove sequential benefit periods from CWF. The chart below includes additional information to cancel CWF benefit periods. The system does not always remove the benefit periods from the CWF records when the cancellation claim(s) is processed. To determine whether or not the benefit periods also need to be cancelled, providers should check the patient’s eligibility records to ensure that the benefit periods have also been removed.

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Submitting the 8XD

Hospices can submit the notice of cancelation (8XD) via the DDE system, EDI or hard copy (if applicable).

For EDI submissions, Medicare encourages hospices to submit batch transmissions with groups of NOEs separate from batch transmissions with groups of claims. This practice may reduce the risk that translator-level rejections related to Notices of Cancelation, if they occur, that could impact payments to the hospice.

Hospices should note that notices of cancelation submitted via EDI are subject to all front-end edits and may be rejected if all required data is not submitted or does not meet the required elements as outlined in the companion guide provided with CR 10064. Electronically filed notices of cancelation will receive a 999 acknowledgment within minutes of submission if accepted. Thus, hospices should also ensure that they monitor their acceptance reports (277CA and 999) at regular intervals. In addition, hospices should be aware that the notice of cancelation is subject to the batching process, which means it may be one to two days before the hospice will see the notice of cancelation in DDE if it was accepted. Once the notice of cancelation is accepted into FISS, processing time may vary as it is subject to all FISS and CWF edits. Therefore, providers are encouraged to also monitor the status of the notice of cancelation in DDE to ensure they make any corrections that may be necessary should the notice of cancelation be RTP for correction.

To complete the 8XD in DDE, select menu option ‘28’ from the claims entry menu. For submission of the notice of cancelation via EDI, follow your software instructions. The table below provides the fields that must be completed when submitting the Notice of Cancelation via DDE, EDI, or hard copy (if applicable). Note: There are additional fields that will be required when submitting the notice of cancelation via EDI.
 

Field Descriptor DDE EDI **Hard Copy (UB-04 by Field Locator [FL]) Description/Valid Values
Provider Name, Address and Telephone Number X X X (FL 1) The DDE system will auto-populate this information based on the NPI that is used for submission of the NOE.

For electronic submission through EDI, check with your software vendor to determine where this information is stored or if you will need to manually enter the information on the claim.
Type of Bill X
(TOB)
Claim Page 01		 X X
(FL 4)		 Enter the type of bill for the NOE. Valid values are:
  • 81D (Freestanding hospice)
  • 82D (Hospital-based hospice)
Statement Covers Period (‘FROM’ Date) X
(STMT DATES FROM)
Claim Page 01		 X X
(FL 6)		 To cancel the NOE, enter the effective date of hospice enrollment in MMDDYY format. The date should match the date submitted on the NOE. This date must match the Admit Date and the date reported with Occurrence Code 27.

To cancel the benefit period, enter the ‘start’ date of the benefit period that is being canceled in MMDDYY format.
Statement Covers Period (‘THROUGH’ Date) X
(STMT DATES TO)
Claim Page 01		 X X
(FL 6)		 This field is only required when submitting the Notice of cancelation through EDI or when canceling a benefit period. When canceling an NOE via EDI, the date must match the “FROM” date.
When canceling a benefit period enter the end date of the benefit period being canceled.
Patient’s Name X
(Last, First, MI) Claim Page 01		 X X
(FL 8)		 Enter the patient’s name as shown on the eligibility file with the surname first, first name, and middle initial (optional), if any.
Patient’s Birth Date X
(DOB)
Claim Page 01		 X X
(FL 10)		 Enter the patient’s date of birth in MMDDYYYY format.
Patient’s Address X
(ADDR 1 – 6 and ZIP)
Claim Page 01		 X X
(FL 9)		 Enter the patient’s full mailing address including street name and number, post office box number or RFD, city, state and ZIP code.
Patient’s Sex X
(SEX)
Claim Page 01		 X X
(11)		 Enter the patient’s sex. Valid values are:
  • M (Male)
  • F (Female)
Admission Date X
(ADMIT DATE) Claim Page 01		 X X
(FL 12)		 When canceling the NOE, enter the hospice admission date. This date must match the date that was submitted on the NOE, which also matches the ‘FROM’ date in the Statement Covers Period and the date reported with Occurrence Code 27.

When canceling the benefit period, enter the ‘start’ date of the benefit period being canceled in MMDDYY format.
Type of Admission   X   Enter a valid Type of Admission Code (1–9).
Admission Source Code   X   Enter the Source of Admission with the default value of ‘1.’
Patient Status Code   X   Enter the patient discharge status code with the default value of ‘30.’
Occurrence Codes and Dates X
(OCC CDS/Date 01 -10)
Claim Page 01		 X X
(FL 31-4)		 Enter Occurrence Code (OC) 27 and the certification date. This date must match the 'FROM' and 'ADMIT' dates.
N/A X
(FAC. ZIP)
Claim Page 01		     The entire nine-digit ZIP code must be entered and should match the facility’s master address in the provider enrollment record (usually the facility’s physical location).
Provider Number X
(NPI)		 X X
(FL 56)		 Enter the NPI associated with the OSCAR number.
N/A X
(OSCAR)
Claim Page 01		     The system will automatically pre-fill the Medicare OSCAR number (the six-digit number assigned by Medicare) when logging on to the DDE system.
Revenue Code   X   Enter the default revenue code 0650.
HCPCS   X   Enter the default HCPCS code Q5009.
Service Date   X   Enter the service date that matches the ‘FROM’ date in the Statement Covers Period.
Total Units   X   Enter the default total units of ‘1.’
Total Charges   X   Enter zeros (0.00)
Payer ID Code X
(CD)
Claim Page 03		 X   Line A – ‘Z’ is system generated in DDE.

Claims submitted via EDI will depend upon the software being used. If the software does not auto-populate this field, enter the ‘Z’ to reflect Medicare as the payer source.
Payer X
(PAYER)
Claim Page 03		 X X
(FL 50)		 Line A – ‘Medicare’ is system generated in DDE.

Claims submitted via EDI will depend upon the software being used. If the software does not auto-populate this field, enter ‘Medicare.’
Insured’s Name X
Claim Page 03		 X X
(FL 58)		 Enter the beneficiary’s name on line A as it appears on the beneficiary’s HI card.

Note: All NOEs are submitted with Medicare as the primary payer.
Certificate/Social Security Number and Health Insurance Claim/Identification Number X
MBI
Claim Page 01		 X X
(FL 60)		 Enter the MBI.

For claims submitted via EDI, this field may vary depending upon the software used. Check with your vendor if assistance is needed.
Release of Information X
(RI)
Claim Page 03		 X X
(FL 52)		 The Release of Information Certification Indicator indicates whether the provider has on file, a signed statement permitting the provider to release data to other organizations in order to adjudicate the claim. Valid values are:
  • I - Informed consent to release medical information for condition or diagnoses regulated by Federal Statutes.
  • Y - Yes, provider has a signed statement permitting release of information.
Principal Diagnosis Code X
(DIAG CODES 01 – 09)
Claim Page 03		 X X
(FL 66)		 Enter all diagnoses as appropriate.
Attending Physician I.D. X
Claim Page 03		 X X
(FL 76)		 Enter the NPI and name of physician currently responsible for certifying the terminal illness and signing the individual’s plan of care.
Other Physician I.D. X
(REF PHYS)
Claim Page 03		 X
(Referring)		 X
( FL 78)		 Enter the NPI and name of the hospice physician responsible for certifying the patient’s terminal illness.

Note: When the hospice physician is the attending and certifying physician, only the attending physician NPI is required to be reported.
Remarks X
Claim Page 04		 X X Enter the reason that the NOE or benefit period is being canceled.
Provider Representative Signature and Date     X
(FL 80)		 A hospice representative must make sure the required physician’s certification and a signed hospice election statement are in the records before signing the Form CMS-1450. A stamped signature is acceptable.

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