I agree with the other posted comments: this form does not apply to the situations that we usually have at our facility.
I am having trouble finding the chapter 30 section 40 and 70 that are referred to. The link takes us to the Medicare Claims Processing Manual. What appears to be Chapter 30 has sections indicated by decimals. There is a 30.4 but no 30.7. Section 30.4 is about PPS coding for ancillary services. What am I missing?
I did find information about the SNFABN in the CMS Beneficiary Notices Initiative (BNI). With reference to the SNFABN (fCMS-10055) the BNI states, "The model form CMS-10055 is a new SNFABN form for use by SNFs. SNFs may begin to use the new SNFABN form immediately." This implies that we also may choose not to use it! It might be useful in situations where a specific treatment or procedure is recommended by the MD and it will not be covered by Medicare. This form does not seem useful for a standard cut letter since it does not present the option of a demand bill. Has the demand bill option changed?
Theresa A Lang <[EMAIL PROTECTED]> wrote:
The entire non-coverage letter form and process changed on 10-1-03 with the
issuance of the CMS Electronic manual system.
The new required form CMS 10055 can be found in the CMS Claims Processing
Manual, Chapter 30, Sections 40 and 70. It is about 30 pages total and is a
significant change from the old non-coverage letters found in the SNF 12
Manual.
http://cms.hhs.gov/manuals/104_claims/clm104index.asp
from this site select Chapter 30- then go to sections 40 and 70
I did attach a pdf copy of the CMS 10055
Theresa Lang
Specialized Medical Services, Inc
Milwaukee WI
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Sue
Junot
Sent: Thursday, November 20, 2003 1:52 PM
To: [EMAIL PROTECTED]
Subject: determination on continued stay.
sorry but I am bain dead today. can someone please direct me to INFORMATION
covering "DETERMINATION ON CONTINUED STAY,DETERMINATION OF NONCOVERAGE,AND
DETERMINATION ON ADMISSION"
THANKS,
SUE, RAC-C
_________________________________________________________________
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> ATTACHMENT part 2 application/pdf name=SNF ABN 11-03.pdf
Caroline Larson, RN, MS, RAC-C
MDS/PRI Coordinator
Fairport Baptist Homes, Fairport, NY 14450
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