The certification of terminal illness (CTI) must contain a summarized narrative explanation of the clinical findings that supports a life expectancy of 6 months or less as part of the certification. CTI reviews are crucial since Medicare cannot make appropriate payment with missing or inadequate information such as dates, signatures and identifying roles of the physician(s). Coding Department offers coding and quality checks to ensure that CTIs will not contain the following common types of missing and inadequate information:

• Predating physician(s) certification signatures
• Not having both the hospice medical director and attending physician (if applicable) sign the initial certification as required
• The physician narrative is missing
• The physician's narrative does not contain a statement attesting that it was composed by the physician
• The attestation statement is missing
• Not having verbal certifications by both the medical director and attending physician (if applicable)
• No physician(s) signatures
• Illegible physician signatures
• Physician did not date his/her signature
• Not clearly stating the dates the certification period encompasses