Thursday, August 21, 2014

Update to the CWF Qualifying Stay Edit C7123 for Inpatient SNF and SB Claims

Dan Ciolek

CMS recently resolved an issue concerning the Common Working File (CWF) qualifying stay edit C7123 to allow Skilled Nursing Facility (SNF) and Swing Bed (SB) claims that contain a valid qualifying hospital stay to bypass edit C7123. SNF and SB providers that have received this edit in error may adjust their affected claims or contact their Medicare Administrative Contractor (MAC) in order to have their claims adjusted.

CMS is currently working on a permanent coding fix for CWF edit C7123 that will address all possible bypass scenarios for the edit. SNF and SB providers should contact their MAC with any questions or concerns.

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