As some of you may have experienced, the hospice certifying physician edit is causing some claims to be rejected in error. The reason code associated with the edit is 17729 - The attending physician's National Provider Identifier (NPI) data on the claim does not match the PECOS Enrolled Physicians File, or the dates do not fall within the physicians effective/termination dates. Claims potentially impacted are those with dates of service beginning on June 3, 2024 and later.
After we heard from some of you that you were receiving these rejections in error, we reached out to the MACs and CMS. Research had to be done to identify the problem and that was completed earlier this week. We heard from CMS a short while ago that a fix is scheduled to be implemented this weekend.
We should have an update next week on whether the implementation was successful and what hospices need to do to get the erroneously rejected claims paid. We will update this post when we have more information.
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Katie Wehri
Vice President of Regulatory Affairs, Quality & Compliance
NAHC
Washington, DC
202-240-9254 #3360
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