Re: Fwd: Medical Devices and Prosthetics

[C Hannant]

WOW!!!  Thank you Delores...Great Job! Cheryl H [EMAIL PROTECTED] wrote: Delores L. Galias, RN, RHIT STATEMENT OF CONFIDENTIALITY: The information contained in this electronic message and any attachments to this message are intended for the exclusive use of the addressee(s) and may contain confidential or privileged information. If you are not the intended recipient, please notify D. Galias, RN, RHIT immediately at [EMAIL PROTECTED] and destroy all copies of this message and any attachments.  Thank you for your cooperation Subject: Re: Medical Devices and Prosthetics From: "CMMInquiry CMMInquiry" <[EMAIL PROTECTED]> Date: Fri, 02 Jan 2004 08:48:05 -0500 To: <[EMAIL PROTECTED]> FAH-11 Dear Ms. Galia: Thank you for your email inquiry concerning a Medicare billing for a resident in a certified SNF. A UB-92 form should be submitted even if a Medicare beneficiary has exhausted their Medicare Part A benefits. When documenting the final UB-92 form, code 22 should be used indicating that benefits have been exhausted and the date of the last covered day on the UB-92 form or the electronic equivalent. The CWF will not show a new benefit period for this resident 60 days after the benefit period has been exhausted. A resident will never have another benefit period as long as they continue to receive skilled care after the benefits are exhausted and the resident remains in a certified bed without a break in skilled care. You may wish to reference Chapter V of the Skilled Nursing Facility Manual for guidance for proper billing procedures at www.cms.hhs.gov/manuals/. Should you require additional assistance regarding this same matter, please include the following reference number: 153990. CAGInquiries 12/01/03 04:27PM >>> Dear Ms. Galias: Thank you for your email inquiry. We are forwarding your inquiry to our Center for Medicare Management. Currently they have a backlog of inquiries, but will respond to you as quickly as they can. <[EMAIL PROTECTED]> 11/29/03 05:32PM >>> FirstName: DELORES LastName: GALIAS Email-address:[EMAIL PROTECTED] Question: have spent hours searching the UGS and CMS website and cannot come up with the documentation I need. Example: Resident is admitted to a certified bed in a SNF. Had at least a 3-day qualifying acute care hospital stay within 30 days of admission to the SNF. Resident needed and SNF provided Total Enteral Nutrition via Gastrostomy tube and met the Skilled guidelines of amount of calories and fluid volume. [Feeding was totally via g-tube, no oral] Medicare Part A Benefits are exhausted, resident continues to receive tube feeding at same level as when receiving Part A benefits and remains in a certified bed. Payment for the tube feeding is now billed to Medicare Part B.. Questions: 1. Does the biller need to send in a UB when benefits are exhausted? 2. How does the biller code the final UB, "no longer skilled care" or "continues to receive skilled care?" And What codes are used for each situation. 3. Will the CWF show a new benefit period for this resident 60 days after benefits have been exhausted? 4. Where can I find these instructions in print either by UGS or CMS? It is my understanding that the resident will never have another benefit period as long as she/he continues to receive skilled care after benefits are exhausted AND the resident remains in a certified bed with no break in skilled care and never leaving a certified bed. Thank you in advance for your reply to this request. Delores L. Galias, RN, RHIT Address1:1981 RANGEVIEW DRIVE Address2: City:GLENDALE State:CA Zip:91201 Country:USA Phone:818 842 5386 Fax: Organization: