----- Original Message -----
Sent: Wednesday, November 26, 2003 9:16
PM
Subject: Re: Tubefeeders
Cheryl,
Getting back to your original question:
I attended a Medicare Billing seminar by Adminastar Federal (Intermediary
for Indiana and others) on 08/12/2003. During a slide presentation, of
which I have a copy, the gentlement stated that " Break in spell occurs
if: 1. Facility-free for 60 days or in noncertified bed (billed as
non-resident) 2. Non-skilled level of care for 60 days.". Most of
the room went WHAT???? This statement obviously has HUGE implications
for those Nursing Facilities that maintain a distinct part as Medicare
certified and do not have all their beds dually certified. I did make a
request for more official documentation and clarification but, of
course, have never received anything.
According to the above, anyone who was a tube feed and was
moved out of the distinct part into a non certified bed would
start a new benefit period after 60 days in that noncertified bed and could
then again, presumably, be skilled for another 100 days for the tube or any
other diagnosis following another qualifying hospital stay.
Cindy Gilmer
C Hannant <[EMAIL PROTECTED]> wrote:
In
agreement w/Denise, understand that I know everything everyone is telling
me. That is not the question. There was supposed to have been a
change to Tube Feeders not being skilled that was published in one of the
monthly newsletters sometime around August. Actually in a CMS
Newsletter. Now we know that they have been making changes and not
getting the word out well, ie August changes that were only found by one of
our members, also the new ABN form that's to start either this fall or next
spring (who knows for sure). That's all I'm asking for is the source
document.
thanks...cher
[EMAIL PROTECTED] wrote:
Just a question, so please
don't bite my head off >GRIN< As if this bunch would.
Thank you in advance for
your replies?
If you have a resident on
Medicare Part A with a Stage IV decub that you can't seem to heal and
they used their entire 100 day benefit period. Would you put them back on
Medicare Part A if after 70 days from being discharged from Medicare
Part A the doctor put the resident in the hospital to repair the same
Stage IV decub with a flap and kept them in the hospital for at least
3 midnight's?
Would this be the same as
the resident being fed via the tube?
ask Sherry Kennedy to show you where the SNF manual
was changed, regarding ending a benefit
period.
I agree with Holly on this one. In ALL my
training from the FI, once a resident reaches a skilled level
and stays at a skilled level exhausting all Part A benefits, there are
no more Part A days. Part B may be different, but Not Part
A.
