DecisionHealth, DecisionHealth - 2011 Issue 4 (April)

CMS: Take action to get paid for incorrectly denied SNF services

You must actively seek reprocessing of claims submitted to Medicare for a variety of radiology and diagnostic ultrasound services via skilled nursing facility (SNF) consolidated billing. Almost all 2011 claims for a total of 37 codes in the 76000 range could potentially be impacted, CMS said in a March 21 posting. The majority of these codes are diagnostic ultrasounds, which were billed to Medicare for the professional component (PC) of each service with modifier 26 (professional component) appended.

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