tci Medicare Compliance & Reimbursement - 2003 Issue 20

PROGRAM MEMO ROUNDUP

Skilled nursing facilities puzzled over Medicare policy for bill types 22x and 23x can take some guidance from a May 9 program memorandum from the Centers for Medicare & Medicaid Services (A-03-040; http://cms.hhs.gov/manuals/pm_trans/A03040.pdf). In the memo, CMS clarifies that bill type 23x should be used for beneficiaries who are placed in a Medicare non-certified part of the facility, while bill type 22x applies for residents who are in non-covered stays but are placed in the Medicare-certified section of the SNF. Bill type 22x is subject to consolidated billing; bill type 23x is not. In other recent...

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