Situation:
Some hospice claims are being Returned to Provider (RTP) with reason code 36188 in error.
Impact to Providers:
The Fiscal Intermediary Standard System (FISS) is inserting Value Code 78 and an amount on Hospice claims that contain the Service Facility National Provider Identifier (NPI), name and address in the 2310E Loop and segments. The FISS is returning the claims to the provider with reason code 36188.
Status:
CMS issued Change Request (CR) 9042 on January 30, 2015, to correct the issue. CR 9042 is scheduled to be implemented during the July 2015 quarterly system release. Until the system release is implemented and the issue is resolved, hospices can remove the Value Code 78 and amount from the claim and resubmit the claim through the Direct Data Entry (DDE) system.
Note from Barnestorm: this is a DDE issue, not a Barnestorm issue. To correct it, when you see a claim in T with 36188, use claim correction to remove the 78 and F9 to resubmit in DDE.