Knowledgebase: Claim Rejections
Medicare (ALL) - Hospice Employee Indicator
Posted by Will Morrow, Last modified by Charmagne Williams on 23 May 2017 03:42 PM

Rejection: Hospice Employee Indicator

What happened: CLM05 (place of service) was sent with the code 34, which stands for hospice, but the CRC segment (Hospice Employee Indicator) was not sent.

Resolution: When CLM05 (place of service) is 34, must send Loop 2400 segment CRC and CRC01 must be 70. Either update in billing software to send that loop and segment, or in claim fix, in the additonal fields section, select either 'Yes' or 'No' in the Hospice Employee section. When done correctly that segment will be sent out correctly.

A "Y' value indicates the provider is employed by the hospice.

A 'N' value indicates the provider is not employed by the hospice.