- Medicare Hospice Quick Reference Sheet
- Hospice Certifying Physician Medicare Enrollment Information
- Hospice Notice of Election Termination/Revocation
- Hospice Room and Board Denials
- Professional Services During a Patient Hospice Election
- Tips to Facilitate the Change of Ownership Process
- Service Intensity Add-on Payment
- Counting 60-Day Election Periods
- Untimely Filed Notice of Election Circumstance Exception: Medicare Beneficiary Is Granted Retroactive Medicare Entitlement
- Hospice Billing Codes Chart
- Appropriate Use of Occurrence Code 27 and Occurrence Span Code 77
- Avoiding Reason Code U5181: Appropriate Use of Occurrence Code 27/Occurrence Span Code 77
- Hospice Notice of Change of Ownership
- Filing an Electronic Notice of Change of Ownership (TOB 8XE)
- Hospice Change of Ownership
- Filing an Electronic Notice of Cancelation (Type of Bill 8XD)
- Filing an Appeal for Claims Rejected for an Untimely Hospice Notice of Election
- Filing an Electronic Notice of Transfer (Type of Bill 8XC)
- Counting 60-Day Election Periods - Leap Year
- Hospice Site of Service Codes
- Billing Hospice Physician, Nurse Practitioner and Physician Assistant Services (Related To Terminal Diagnosis)
- Correcting Hospice Claims Sequentially to Avoid Reason Code U5181
- Common Working File System Edit F5052 and M5052
- Hospice Visit Reporting
- The Medicare Hospice Benefit: Effects on Other Provider Types
- Counting 90-Day Election Periods - Leap Year
- Reporting Hospice Discharges, Revocations and Transfers
- Filing an Electronic Notice of Termination-Revocation of Election (Type of Bill 8XB)
- Avoiding Reason Code 7C625: Appropriate Use of Remarks on Final Hospice Claims
- Notice of Election: Timely Filing of Hospice Elections
- Hospice Claim Submission Job Aid
- Direct Mailing Notification to Hospice Providers Regarding the Hospice Benefit Component, VBID Model, Participating MAOs
- Counting 90-Day Election Periods
- Hospice Quality Reporting Program
- Filing an Electronic Notice of Election (Type of Bill 8XA)
- Hospice Prescription Drug and Infusion Pump Reporting
- Hospice Caps Job Aid
- Value-Based Insurance Design Model Hospice Benefit Component Overview
- Documentation for Hospice Transfers
- Hospice Billing Instructions for Influenza, Pneumococcal and Hepatitis B Vaccines
- Appropriate Use of Condition Code 85
- How to Correct/Avoid Reason Code U5150
- General Inpatient Check Off List
- Hospice Transfers Job Aid
- Medicare Two Tier Routine Home Care Payment Rate
- Canceling a Hospice Notice of Election
- Hospice Pricer Tool Quick Reference Tool
- How to Bill When the Hospice Face-to-Face is Late from a Previous Benefit Period
- Site of Service Codes for Continuous Home Care and General Inpatient Care Level of Service
- Hospice Payment Rates
- Billing Medicare for a Denial - Condition Code 21
- Reminder on Deleting Revenue Code Line(s) in the Fiscal Intermediary Standard System Direct Data Entry System
Correcting Hospice Claims Sequentially to Avoid Reason Code U5181
Hospice Sequential Billing
Sequential billing is required in order for the Medicare claims processing system to appropriately match claims to benefit periods and ensure accurate payment. The Medicare system stores data from submitted notices and claims to edit and process claims for payment. Sequential billing of claims is essential for efficient and accurate processing of claims.
Hospices are required to bill claims sequentially per calendar month billing and not a thirty-day billing period. For example an April claim (0401XX) must be submitted before a May (0501XX) claim. The April claim must process and finalize before the May claim will process. FISS will search the claim history for a prior a claim. There cannot be any skipped dates between the “TO’ date and the next month’s claims “FROM” date, or the claim will move to RTP.
When sequential billing requirements are not followed, the claim will RTP (status/location T B9997). If the prior claim is in the RTP file (T B9997) and needs correcting, the subsequent claim will be sent to the RTP file with reason code 37402. FISS does not search the RTP file (T B9997) for prior claims.
Correcting Claims Sequentially
When claims need corrected it is important to correct claims in sequential order, the FISS system will not search the RTP file (T B9997) for prior claims. Claims are returning to providers with reason code U5181 when claims are adjusted out of order. RTP claims must be adjusted and corrected out of RTP and sequentially.
For example if claims have been submitted for April and May. The April claim needs to be adjusted. The May claim will need to be cancelled, and the April claim adjusted. Once the April claim has processed and finalized the May claim can be resubmitted.
If the April claim RTPs for example an invalid HCPCS code, and the May claim was submitted, The May claim would go to RTP because no prior claims was found. You must first correct the April claim. Once the April claim is corrected and moved to a suspended status/location, the May claim can be PF9ed out of RTP.