CMS HPMS Memo, Part D Payment for Drugs for Beneficiaries Enrolled in Hospice—Request for Comments (Dec. 6, 2013), § Attachment 2- Daily Transaction Reply Report (DTRR) (excerpted from PCUG)

F.14.1 DTRR Data File Detailed Record Layout

Item Field Size Position Description

12 Hospice Indicator 1 54 ‘1’ = Hospice;

‘0’ = No Hospice;

Space = not applicable.

15 Transaction Reply Code (TRC) 3 57-59 TRC, see TRC list on page I-2 for

values

18 Effective Date 8 63-70 YYYYMMDD Format;

Effective date is present for all TRCs.

24 Positions 85 – 96 are dependent 8 85-92 This field value depends on the TRC

upon the TRC value. There are that is returned on the reply. See the

spaces for all codes except where TRC-related values below:

indicated below.

e. Hospice Start Date 8 85-92 YYYYMMDD Format; Present only

when TRC is 71

f. Hospice End Date 8 85-92 YYYYMMDD Format; Present only

when TRC is 72

Table I-2: Transaction Reply Codes

Code Type Title Short Definition

Definition

071 M Hospice HOSPICE This TRC is returned on a reply with Transaction Type 01 and occasionally

Status ON with Transaction Type 51, and Transaction Type 61. When returned with

Set Transaction Type 01, the TRC is in response to a change in beneficiary

Hospice status. It is not a reply to a submitted transaction but is intended to

supply the Plan with additional information about the beneficiary.

In the case of Transaction Type 01, a notification has been received that this

beneficiary is in Hospice status. The date on which Hospice Status became

effective is reported in DTRR data file fields 18 and 24.

The effective date for Hospice Status is not restricted to the first or last day of

the month. It may be any day of the month.

When this TRC is returned with Transaction Type 61 the TRC is in response

to a retroactive enrollment and is identifying the fact that an enrollment end

date has been established due to the beneficiary’s hospice status. The

enrollment start date is in DTRR data file field 18 and the enrollment end date

is in field 24. In this circumstance it is accompanied by TRC 018, Automatic

Disenrollment, as well.

072 M Hospice HOSPICE This TRC is returned on a reply with Transaction Type 01. It is not a reply to

Status OFF a submitted transaction but is intended to supply the Plan with additional

Terminat information about the beneficiary.

ed A notification has been received that this beneficiary’s Hospice Status has

been terminated. The end date for the Hospice Status is reported in DTRR

data file fields 18 and 24.

The date for termination of Hospice Status is not restricted to the first or last

day of the month. It may be any day of the month.