Reason Code U5211

Description
The dates of service (“From” and “To” dates) on the claim overlap the date of death on file for the patient at Common Working File (CWF).

Resolution

• Review the beneficiary's eligibility record to determine the date of death on file
• If the date of death is correct, submit an adjustment (type of bill XX7) to your claim, ensuring that the “To” date of the claim, and the line item dates of service, do not overlap the date of death on file
• If the date of death is incorrect, contact the Social Security Administration to advise of the incorrect date of death. Monitor the beneficiary's eligibility file for the date of death to be corrected. Once corrected, submit an adjustment (type of bill XX7) to your claim. (See "Additional Information" section below.)
  • Note: Do NOT adjust your claim until the incorrect date of death has been corrected or removed

Additional Hospice Information
If a hospice benefit period has been shortened due to the incorrect date of death, the shortened benefit period must be corrected before the claim can be adjusted. To correct the shortened benefit period the hospice has two options:

• Option 1: Cancel any paid claims with a date of service that falls within the shortened benefit period. Then submit an 8XD to delete the shortened benefit period. Example: Shortened benefit period: January 5 – March 6. The March claim rejected for U5211. The February claim must be cancelled. Then the January claim must be canceled. Then an 8XD must be submitted with a January 5 date. Once the benefit period has been removed, a new NOE and claims must be submitted sequentially.
• Option 2: Contact the Provider Contact Center to request assistance in removing the shortened benefit period. Palmetto GBA will forward your request to the CWF maintainer, who will correct the shortened benefit period. In this case, the provider must monitor CWF to determine when the benefit period has been corrected.