General Surgery Coding Alert - 2004 Issue 44
Double Counseling Could Cost Hospices $55 Per Patient
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Article Overview
This piece summarizes CMS instructions affecting hospice billing and Medicare payment for an initial hospice consultation service. It is aimed at hospice billers, coding staff, compliance teams, and physicians who need to understand the general scope of the new HCPCS service, the billing pathway used by hospices, and the fact that duplicate claims are not payable. The article focuses on Medicare policy guidance and the operational details surrounding claim submission and eligibility for payment.
Why This Topic Matters
Hospices need to understand the payment and billing framework for this Medicare service to avoid denied claims and compliance problems. The article highlights how CMS expects the service to be billed and paid, making it relevant to revenue cycle and coding operations.
What You Will Learn
- The general purpose of the new hospice consultation payment guidance
- How hospice billing for the service is structured at a high level
- What CMS says about who submits the claim and how payment is handled
- Why duplicate claims for the service are an issue under Medicare policy
Who Should Read This
- Hospice billers
- Medical coders
- Revenue cycle staff
- Compliance teams
- Hospice physicians
- Medicare reimbursement specialists
Codes Discussed
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