This is from the new online Medicare Benefit Policy Manual
Chapter 8 - Coverage of Extended Care (SNF) Services Under Hospital Insurance
20.1 - Three-Day Prior Hospitalization
(Rev. 1, 10-01-03)
A3-3131.1, SNF-212.1
"To be covered, the extended care services must have been for the treatment of a condition for which the beneficiary was receiving inpatient hospital services, including services of an emergency hospital, or a condition, which arose while in the SNF, or for treatment of a condition for which the beneficiary was previously hospitalized. In addition, the qualifying hospital stay must have been medically necessary..."
20.2 - Thirty-Day Transfer
(Rev. 1, 10-01-03)
A3-3131.3, SNF-212.3
20.2.1 - General
(Rev. 1, 10-01-03)
A3-3131.3.A, SNF-212.3.A
"Post-hospital extended care services represent an extension of care for a condition for which the individual received inpatient hospital services. Extended care services are âpost-hospitalâ if initiated within 30 days after discharge from a hospital stay that included at least three consecutive days of medically necessary inpatient hospital services."
Rena
Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
[EMAIL PROTECTED]
Subj: medicareI have q uestion here. If sombody can help me with this. We have a resident that was taken off from Medicare A as of 12/12/03. This pt. has GT site but we're not using it except for flushing. She had modified barium swallow last december and it showed Zenker's Diverticulum. Just last friday, MD ordered to put resident on NPO and start the GT feeding. Now, we are arguing if we can put resident back to part A since she is still on 30 day window as of today. I really need response for this for Our meeting in AM. thanks a lot for ther response.
Date: 1/12/04 10:05:07 PM Pacific Standard Time
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