Medicare Agencies Get New Occurrence Code

Code 55 for Use in Reporting Date of Death

Effective Oct.1, 2012 Medicare certified agencies (including home health and hospice providers) will be required to use occurrence code 55 to indicate a date of death on claims. The new occurrence code will be used in conjunction with discharge status codes indicating the patient has expired – 20 (expired), 40 (expired at home), 41 (expired in a medical facility), or 42 (expired – place unknown). Additional information on the use of code 55 can be found in Change Request 7792. Once effective the new occurrence code 55 to report the date of death is a required code — which means it will be applicable for all claims, including private insurance.

Addition of the new occurrence code was sought to ensure that beneficiaries are not erroneously registered as deceased as the result of miskeying of the discharge status code. While the frequency with which this occurs is low, when it does happen it creates significant difficulty for beneficiaries and other providers. It is believed that use of the new code, in conjunction with the discharge status code, will help to protect beneficiaries from the consequences of miscoding.


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