Fix date of death errors in Medicare records
Sometimes Medicare records incorrectly show that a patient has died, or the records list the wrong date of death. When this happens, Medicare will not reimburse the claim until the records are corrected.
Provider claim error
If a provider submits a Medicare Part A claim that incorrectly reports a date of death, submit a claim adjustment.
Scenario 1: The patient is still alive. Provider submits a claim adjustment to remove the date of death:
- Change the discharge status code - replace codes 20, 40, 41, or 42 (which indicate the patient died) with the correct code that reflects where the patient went after discharge
- Remove occurrence code (OC) 55 and the associated date of death from the claim
Scenario 2: The patient died, but the date of death is wrong. Submit a claim adjustment to correct the date of death:
- Keep the discharge status as “expired”
- Update OC 55 with the correct date of death
For more information about adjusting Part A claims, read the article Claims: Adjusting, reopening, cancelling, and resubmitting.
Social Security Administration or Railroad Retirement Board error
If the error is in a Social Security Administration (SSA) or Railroad Retirement Board (RRB) record, the agency responsible for the patient’s Medicare eligibility record must fix the error before an update can be made to the patient’s eligibility.
The agency responsible can:
- Remove the date of death if the patient is alive
- Fix an incorrect date of death after the patient, a family member, or an authorized representative contact the agency and provides the required documentation
Contact information:
• SSA: 1-800-772-1213 or www.ssa.gov
• RRB: 1-877-772-5772 or www.rrb.gov
As a reminder, Medicare will not reimburse the claim until the eligibility records reflect the correct information.
Reference