decisionhealth Newsletters, Answer Books - 2006 Issue 3 (March)
Program_Memos / 2002 / B-02-076
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Article Overview
This article explains a CMS Program Memorandum that updates skilled nursing facility consolidated billing edit maintenance for Medicare claims processing. It is relevant to carriers, CWF contractors, and billing staff who track annual code-file changes, edit maintenance, and notification procedures tied to SNF billing operations. The article focuses on implementation timing, system update responsibilities, and references to related CMS instructions.
Why This Topic Matters
It helps readers understand how CMS coordinated annual SNF consolidated billing file updates and claim-processing changes in 2002–2003. The guidance is useful for organizations responsible for Medicare edit maintenance, claim reprocessing, and communicating updated code files to providers and suppliers.
Article Sections
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General Information
Provides background and policy context for the annual update to skilled nursing facility consolidated billing edits in Medicare processing systems.
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Business Requirements
Outlines system and contractor responsibilities for updating code lists, comparing edit files, handling deletions, and supporting carrier processing activities.
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Supporting Information and Possible Design Considerations
Lists related CMS instructions and other implementation notes associated with the update.
What You Will Learn
- How CMS organized annual updates for SNF consolidated billing processing.
- Which organizations were responsible for code-file comparison and edit maintenance.
- What implementation and communication steps accompanied the update.
- How the memorandum relates to other CMS SNF consolidated billing instructions.
Who Should Read This
- Medicare carriers
- CWF contractors
- Medical coders
- Billing staff
- Revenue cycle staff
- Provider administrative staff
Modifiers Discussed
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