Hospice medical review top denial reason dodes: Q4 2024

03/24/25 at 03:00 AM

Hospice Medical Review Top Denial Reason Codes: Q4 2024 [Palmetto GBA]
Palmetto GBA press release; 3/17/25
We encourage all providers to review this information when filing claims to prevent denials and to ensure their claims are processed timely. The following information affects providers billing 81X bill types.

  1.  5CF36 Not Hospice Appropriate
  2.  56900 Auto Denial — Requested Records not Submitted
  3.  5CNER The Notice of Election Is Invalid Because It Doesn't Meet Statutory/Regulatory Requirements

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