CMS Transmittal R3032CP (CR 8877), § Business Requirements Table

"Shall" denotes a mandatory requirement, and "should" denotes an optional requirement.

Number Requirement Responsibility

A/B D Shared- Other

MAC M System

E Maintainers

A B H F M V C

H M I C M W

H A S S S F

C S

8877.1 Contractors shall be aware of the hospice policy X

changes associated with this update to the Internet

Only Manual.

8877.2 The contractor shall request documentation from the X

hospice to support its request for an exception to

waive of the consequences of late filing of a notice of

election when the claim reports:

• Type of bill 081x or 082x, and

• A KX modifier is associated with the Q

HCPCS code on the earliest dated level of care

line item (revenue codes 0651, 0652, 0655 or

0656).

8877.3 If the hospice documentation supports an allowable X

exceptional circumstance, then the contractor shall :

• apply the CWF override code,

• remove the occurrence span code 77 from the

claim, and

• move any non-covered charge amounts to

covered charges in order to allow payment for

the provider liable days.

8877.4 When a contractor does not approve a request for an X

exception, the contractor shall process the claim as

submitted, with the provider liable days.

Note: Due to a systems limitation, remittance advice

remark code N211 (you may not appeal this decision)

will be applied to the provider liable days in error.

These days are appealable. This will be corrected in a

future CR.