Monday, April 13, 2015

CMS Updates Several SNF Policies that Impact Billing

The Centers for Medicare and Medicaid Services (CMS) recently issued a MLN Matters article titled Updates to the Medicare Internet-Only Manual Chapters for Skilled Nursing Facility (SNF) Providers. This article summarizes updates to sections of the Medicare Benefit Policy Manual and the Medicare Claims Processing Manual in regards to SNF policy and billing. These policy updates are effective June 15, 2015. AHCA members are encouraged to review and forward to your billers.  
Policy areas updated include:
  •        Definition of what qualifies as a readmission to a SNF
  •         Excluded services beyond the scope of a SNF Part A benefit
  •         SNF consolidated billing annual update process
  •         Health insurance prospective payment system (HIPPS) rate code link
  •         Coding SNF PPS bills for ancillary services
  •        Adjustment requests
  •         SNF PPS pricer software
  •        Annual updates to SNF PPS pricer
  •         Leave of absence (LOA)
  •         Transportation of equipment billed by a SNF to a MAC 

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