- 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
How to Correct/Avoid Reason Code U5150
When a Medicare hospice eligible individual elects hospice, the hospice must submit a NOE to the Medicare contractor prior to submitting claims for payment. The NOE transmits the hospice information to the CWF. Once the initial NOE is processed (status/location P B9997), CWF maintains the beneficiary in hospice status (until death or until an election termination is received) and the hospice can begin submitting claims for payment.
If the NOE is not processed prior to submitting the first claim, the claim will be RTP with reason code U5150. The FISS reason code U5150 the narrative states, “Hospice claim received and no hospice master record present for this beneficiary.”
How to Correct This Reason Code
Check the FISS Claims Inquiry file to verify the NOE has been processed and appears in status/location (S/LOC) P B9997 prior to resubmitting the claim. To access the Claims Inquiry file from the FISS/DDE Provider Online System, follow these steps:
Step | Action |
---|---|
1 | From the FISS Main Menu, Key 01 (Inquiries) in the ENTER MENU SELECTION field |
2 | <Enter> The Inquires Menu will be displayed |
3 | Key 12 (Claims) in the ENTER MENU SELECTION field |
4 | <Enter> The initial CLAIM SUMMARY INQUIRY Screen will be displayed |
To perform searches within the CLAIMS SUMMARY INQUIRY option, type any of the following criteria to obtain a list of claims (Note: At a minimum, either the MBI or the status/location must be included in your claim search):
Field | Description |
---|---|
NPI | Enter your ten-digit NPI |
MBI | Enter the MBI for the beneficiary |
PROVIDER | Enter your provider number |
S/LOC | Enter the status/location (e.g., P B9997) |
TOB | Enter the bill type (e.g., 811) |
OPERATOR ID | Enter the operator identification number of the person who keyed the claim |
FROM DATE | Enter a specific From date in MMDDYY format |
TO DATE | Enter a specific Thru date in MMDDYY format |
If the NOE has not been submitted yet, submit it and wait for it to finalize prior to resubmitting the claim. Remember the NOE must be processed before resubmitting your claim.
How to Avoid This Reason Code
The NOE should be filed as soon as possible after a patient elects the hospice benefit. By submitting the NOE timely, other providers will see that the patient is in the Medicare hospice benefit. This helps to avoid inappropriate billing to Medicare contractors by non-hospice providers, and can help to avoid inappropriate billing by other hospices.
The NOE must be submitted and processed prior to submitting the first hospice claim to Medicare. Once the NOE is processed, the hospice can begin submitting claims to National Government Services for payment. Never submit an NOE and claim on the same day, and always check the claims system to make sure that the NOE is submitted and processed before submitting any claims to Medicare.
Related Content
- Chapter IV - Inquiries Submenu (01), of the Fiscal Intermediary Standard System/Direct Data Entry Provider Online Guide
- CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 11 Processing Hospice Claims
- CMS IOM Publication 100-04, Medicare Claims Processing Manual, Chapter 25 Completing and Processing the Form CMS-1450 Data Set
- CMS IOM Publication 100-02, Medicare Benefit Policy Manual, Chapter 9 Coverage of Hospice Services Under Hospital Insurance