Top Claim Submission Errors for Hospice Providers: Error 34952
Reason for error: This reason code indicates that a service facility National Provider Identifier (NPI) was required on the claim, but was not reported. As required in Change Request 8358, effective for dates of service on/after April 1, 2014, hospice providers are required to report a service facility National Provider Identifier (NPI) when billing any of the following place of service HCPCS codes:
- Q5003 – hospice care provided in nursing long term care facility (LTC) or non-skilled nursing facility (NF)
- Q5004 – hospice care provided in skilled nursing facility (SNF)
- Q5005 – hospice care provided in inpatient hospital
- Q5006 – hospice care provided in inpatient hospice facility (when not the same as the billing hospice)
- Q5007 – hospice care provided in long term care hospital (LTCH)
- Q5008 – hospice care provided in inpatient psychiatric facility
Claim processing result: Return to Provider (RTP)
How to prevent/resolve:
- Before submitting your claim, check to see if any of the above HCPCS are present.
If present:
- The NPI of the nursing facility, hospital, or inpatient facility where the patient received services is required. Enter the service facility NPI in:
- Loop 2310E (when billing in the 5010 electronic claim format); or
- SERV FAC NPI field in the Fiscal Intermediary Standard System (FISS) on Claim Page 03.
- The NPI of the nursing facility, hospital, or inpatient facility where the patient received services is required. Enter the service facility NPI in:
Posted: 12.11.18