US · guidance
CMS Transmittal R13074CP (CR 13882), § Summary of Changes
Summary of Changes
I. SUMMARY OF CHANGES: The purpose of this Change Request (CR) is to provide an updated list of
unacceptable principal diagnosis codes under the hospice benefit. The CR also updates section 30.3 of
chapter 11 of the Claims Processing Manual, to provide updated guidance regarding non-reportable principal
diagnosis codes, section 40.2, to provide clarification of liability for claim denials during a hospice election,
and section 50, to include “related conditions” so that the Manual is consistent with Federal Regulations and
the Federal Register.
EFFECTIVE DATE: April 1, 2025 - for claims received on or after 4/1/25
*Unless otherwise specified, the effective date is the date of service.
IMPLEMENTATION DATE: April 7, 2025 - Non- System Requirements; July 7, 2025 - FISS
Requirements
Disclaimer for manual changes only: The revision date and transmittal number apply only to red
italicized material. Any other material was previously published and remains unchanged. However, if this
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table of contents.
History
Pub. 100-04 Transmittal 13074 (CR 13882), issued March 13, 2025, effective April 1, 2025: "Principal Diagnosis Code Reporting Update for Hospice and Manual Updates to Sections 30.3, 40.2, and 50 of Chapter 11 of the Claims Processing Manual: Processing Hospice Claims".
Provenance
- Source
- cms.gov
- Retrieved
- 2026-09-17
- Edition
- hospice-memos-2026-09-17
- Content hash
3be8674ec60376768b7c0ee4a9abdc741fe86eff05b6111bf1e253e8bce3bd74
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