CMS Invalid Hospice Diagnosis Codes

Hospice providers should be aware of the list of “Invalid Hospice Diagnosis Codes” which should not be used as a primary diagnosis for a hospice patient for dates of service beginning October 1, 2014 or later.

The Centers for Medicare and Medicaid Services issued CR 8877, "Hospice Manual Update for Diagnosis Reporting and Filing Hospice Notice of Election (NOE) and Termination or Revocation of Election" on August 22, 2014.  At that time NHPCO advised the field and created a compliance update document in late August with the details of all provisions of CR 8877.

Recently, the Regulatory Team at NHPCO has received numerous questions about the invalid diagnosis codes contained in Attachment A of this CMS Change Request.  Of particular importance are coding guidelines related to:

• ICD-9-CM/ICD-10-CM Coding Guidelines
• ICD-9-CM/ICD-10-CM Dementia Coding Guidelines
• Hospice Invalid Principal Diagnosis Codes 

Providers should be familiar with the provisions of CR 8877, "Hospice Manual Update for Diagnosis Reporting and Filing Hospice Notice of Election (NOE) and Termination or Revocation of Election." This Change Request provides a manual update and provider education for CMS edits in place for principal diagnoses that are not appropriate for reporting on hospice claims.

NHPCO members looking for assistance with CR 8877 will find a Regulatory Alert (10/02/14) posted on the NHPCO website that includes a link to the original compliance update document released last August.