Hospice Claims Processing Procedures When Required Face-to-Face Encounters Do Not Occur Time
When a required face-to-face encounter does not occur timely, the beneficiary is not considered terminally ill for Medicare purposes due to lack of recertification, and therefore is not eligible for the hospice benefit. A hospice must discharge the patient but can re-admit once the encounter occurs. Use of occurrence span code 77 is not appropriate when a required face-to-face encounter does not occur timely.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: October 07, 2011
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