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Last Modified: 4/6/2018 Location: FL, PR, USVI Business: Part A

Claims overlap FAQs

Q: How do I bill my claims when a patient revokes or elects hospice coverage during his/her inpatient stay?
A: Electing or revoking the Medicare hospice benefit is the beneficiary’s choice. The patient or his/her representative may elect or revoke Medicare hospice care at any time in writing. The hospice cannot revoke the beneficiary’s election, nor request or demand that the patient revoke his/her election. If the patient revokes his/her hospice election, Medicare coverage of all benefits waived when hospice care was initially elected resumes under the traditional Medicare program. The information below provides a general guidance on how to submit claims.
When a beneficiary elects hospice during an inpatient stay:
Bill traditional Medicare for period before hospice election
Patient status code is 51 (discharge to hospice medical facility)
Discharge date is the effective date of hospice election
Bill hospice for period of care after hospice election
When a patient revokes hospice during an inpatient stay:
Bill hospice for period up to hospice revocation
Bill traditional Medicare for period after hospice revocation
Admission date is same as the hospice revocation date
Statement from date is the same as the hospice revocation date
Click here for additional information on claims rejecting with reason code C7010.
Source(s): CMS internet-only manuals (IOM), publication 100-02, Chapter 9 external pdf file;
MLN Matters Article number SE0801 external pdf file
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