May 1, 2009, Home Health & Hospice Medicare A Newsline - CGS

News from Cahaba for Hospice ProvidersMedicare ForumDo you have a Medicare question or topic that you would like addressed in the Home Health & HospiceMedicare A Newsline? If so, fax it to the Provider Outreach and Education (POE) department at 515-471-7584, or e-mail it to ianewsline@cahabagba.com. Please include your facility’s name and provider number,your name and telephone number. Responses to the inquiries received in this e-mail box will be providedonly through the Medicare Forum article, if appropriate. If you need an immediate response to a question,please contact a Provider Contact Center for assistance. Refer to the “Contact Us” page of our Web site andselect “Phone Us” to call a Customer Service Representative (CSR). We also welcome your comments orsuggestions on this publication and other Cahaba customer service activities.Q1. I would like a little clarification regarding when a hospice patient is living in a skilled nursingfacility and that is their declared residence and they die. What would be the appropriatedischarge reason code; 40 expired at home or 41 expired at medical facility? If there issomething that I could print out for reference that would be very helpful.I would be billing to Medicare at the routine home care level of care.A1. The Centers for Medicare & Medicaid Services (CMS) as well as the National Uniform BillingCommittee (NUBC) do not provide a definition of what is considered a patient’s place of residence inregard to the patient status codes. Therefore, because the patient status codes 40 (expired at home),and 41 (expired in a medical facility) are not used to determine reimbursement or coverage, wesuggest that you use the code you believe to be the most appropriate.Home Health & Hospice May 1, 2009 27Medicare A Newsline Vol. 16, No. 8