Both of our FI's, Mutual of Omaha and BlueCross/BS of MD, expect that we
will put all ancillary charges on the UB92 for the MCA PPS patient, even if they
occurred on the day of discharge. This would include therapy, medications
administered, lab test done, etc. No payment is made for the day of discharge,
but all ancillaries are bundled into the MC cost report.
A patient who is a "same-day discharge" would also have all ancillaries on
the bill, which is a non-utilization day, but for which we would get a RUG
payment.
On Mon, 19 Jan 2004 10:24:25 EST [EMAIL PROTECTED] writes:
Even though this excerpt from the regulation seems clear enough, I'm still not clear on one point. These ancillary charges from the day of discharge were included in the pre-PPS cost information that the PPS rates were built on via the cost report. My assumption is that these ancillary charges still should end up on the cost report, and that would be via the UB-92 claim form. Maybe the regulation is saying that it is not permissible to bill Part B for the charges. Does anyone out there have information from your FI on this?
In the meantime, Faye, I recommend that your biller contact your facility's FI and find out if the charges should be on the UB. While it is true that the facility will not be reimbursed for these charges, all allowable costs as reflected on all facilities' cost reports will be analyzed nationally to determine if PPS rates should be increased. If we don't capture all costs, we are hurting ourselves. (Okay, I won't get started on my soapbox about how eliminating Medicare certified units dilutes the costs...)
Rena
Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
[EMAIL PROTECTED]Subj: RE: billing ancillary svc day of discharge
Date: 1/19/04 2:47:31 AM Pacific Standard Time
From: [EMAIL PROTECTED]
Reply-to: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent from the Internet
Thank you. We figured this was the answer but she was hoping. I appreciate the reference.
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of [EMAIL PROTECTED]
Sent: Saturday, January 17, 2004 12:12 PM
To: [EMAIL PROTECTED]
Subject: Re: billing ancillary svc day of discharge
Ancillary services are not billable on the day of discharge.
This is from the Medicare Claims Processing Manual, which can be found at http://cms.hhs.gov/manuals/104_claims/clm104c06.pdf
Chapter 6 - SNF Inpatient Part A Billing
40.3.5 - Determine Utilization on Day of Discharge, Death, or Day Beginning a Leave of Absence
"Also, if no-payment is possible under PPS, billing is not allowed for ancillary services. Ancillary charges for these days have been included in the PPS rates for days that can be billed."
PPS is an all-inclusive per diem payment (except for the few services excluded from consolidated billing) and therefore billing ancillary charges would not result in payment anyway.
Rena
Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
[EMAIL PROTECTED]
Subj: billing ancillary svc day of discharge
Date: 1/14/04 8:37:37 AM Pacific Standard Time
From: [EMAIL PROTECTED]
Reply-to: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent from the Internet
My billing person has a question. Resident received PT on day of discharge and she wants to know if we can bill for the ancillary svc provided that day. If the answer is yes could you provide where she might find the info she needs to do this. Thanx, Faye
To admit you were wrong is to declare you are wiser now than before.
--Unknown
