Reason Code B9 - JA DME

Common Reasons for Denial

• Patient is enrolled in a hospice program.

Next Step

• Check for hospice care enrollment. This can be verified on the Noridian Medicare Portal under Eligibility and the Hospice tab.
  • If on hospice and item is under hospice diagnosis:
    • Purchased item - Bill appropriate hospice facility for item provided
    • Rental item - Pick up equipment and notify facility providing the hospice care. The facility providing the care can be found under claim status, Expanded Denial Details and the Hospice Denial Details

How to Avoid Future Denials

• Ensure that Eligibility is verified on the Noridian Medicare Portal under the Hospice tab and that appropriate diagnosis and modifiers are appended to claim line when applicable. When the item is billed unrelated to the Hospice diagnosis, the GW modifier should be appended to the claim line.