Effective Date: January 1, 2017
Implementation Date: January 3, 2017
Occurrence span code 77 is currently used for both late re-certifications and late NOE’s, and the Medicare system is having difficulty distinguishing when the 27 certification date should fall within the 77 span dates or not. Change Request (CR) 9590 creates a new condition code for hospices to use to identify when an occurrence span code 77 period is caused by a late recertification of the terminal illness. Note that CR9590 creates no new policy.
The new condition code 85 is effective on January 1, 2017 and is defined “Delayed recertification of hospice terminal illness.” When hospices report this code, Medicare systems will ensure the occurrence code 27 date does not fall within the OSC 77 dates. Your 27 code date will be the actual recertification date, which should fall the date after the occurrence span with the 85 Code.
To review, go to:
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3577CP.pdf