Hi Jen,

 

I was afraid you were going to ask me for a reference, because I can’t remember where I got that information from, but I think it was one of the other MAC’s (CGS maybe).

 

And as far as the modifier question, I’m not 100% sure if you need to add a modifier, but I’m hoping some of our savvy billers might know J I believe our process is to use a DC status of “Transfer to Hospice” for our HH claim.

 

Would love to hear how others are doing this.

 

Vickie

 

 

 

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Thanks Vickie, that is what I thought but couldn’t find this written anywhere.  Do you have a reference anywhere for the below?

Also, do you know if there is a special code or modifier (or something else) that billing should be including on the claim to prevent a rejection?

Thanks again!

 

 

 

Hi Jen,

 

Medicare allows you to bill a home health discharge and a hospice admit on the same day.

 

If a beneficiary is transferred out of HH services the same date that they are admitted to a hospice agency, there may be a home health visit on the same date. In such circumstances, the HHA will discharge the beneficiary to hospice care during the last HH visit and the hospice agency will admit to their services.

 

However, we have had a claim denied from a private insurance for this scenario (I can’t remember which one), so I guess it depends on the payer.

 

 

 

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Hi,

Could someone clarify for me whether we can discharge a patient from Medicare home health services and admit to Medicare hospice services on the same day?  I believe we have done this in the past, as we want to make sure the patient actually elects hospice prior to discharging, but billing indicates these claims may go to a T status due to the overlap.  The dx would relate to the hospice terminal as the patient is transitioning from skilled home care to hospice due to declining status.  I appreciate any insight others may have.

Thanks

 

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