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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 8358External PDF, 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.

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Posted: 12.11.18

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