RE: Coming off PPS

[Theresa A Lang]

The physician must be notified- the regulations indicate that a notice of the non-coverage letter must go to the physician. some facilities use a TO to take off Medicare as this notice rather than sending the non-coverage letter  now called the ABN. I have inserted the quote from the CMS Claims Processing Electronic Manual effective 10-1-03. Although this statement was present in the SNF 12 manual as well.   Theresa Lang Specialized Medical Service,Inc Milwaukee WI   70.1.1 - Approved Model Form (Rev. 1, 10-01-03) The SNFABN (viz., CMS-approved model Form CMS-10055) is for use with SNF PPS services. This form satisfies the requirements under LOL for advance beneficiary notice and the beneficiary�s agreement to pay. The use of any other notices or of modified SNFABNs may be ineffective in protecting users from liability. The SNFABN must be prepared with an original and at least one patient copy, a SNF copy containing the signature of the patient or authorized representative, an attending physician copy, and (when necessary) a Medicare contractor copy. SNFs may produce SNFABNs using self-carboning paper and other methods of producing copies, including photocopying, printing, and electronic generation, but they should conform to the Form CMS-10055 design. -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of sheppard70057rn Sent: Sunday, November 16, 2003 5:24 PM To: [EMAIL PROTECTED] Subject: Coming off PPS I wouldlike to post this one more time.  I did receive two responses to it but it still does not clarify the question for me.   When a resident comes off of MEDICARE PPS do you need to write an order discharging resident off of PPS?   There was some confusion with one response that I received on this in regards that it was being interpreted that I was talking about MEdicaid skilled.  This is in regards to PPS.     Dawn Sheppard, RN, CRNAC