I am feeling a little confused. Seems like this thread has
come up many times in the past with the upshot being that
you can bill for the day of discharge as long as it is also
the day of admission.
We do not have experience with this at our facilty but when
I read the following excerpt from the SNF manual it seems
that the SNF is allowed to bill for ancillaries, just not
accommodation.
517.6 Determining Whether a Part of a Day is a
Utilization Day.--
Day of Admission.--The day of admission counts as a
utilization day except in the situation where the patient
was admitted with the expectation that he remain overnight
but was transferred to another participating provider before
midnight of the same day. In this instance, the first
provider shows "1" in Item 24, Noncovered Days and "0" in
Item 23, Covered Days, and does not complete Item 60,
Inpatient Deductible or Item 61, Coinsurance, or make a
deductible or coinsurance charge to the patient. The
provider to which the patient was transferred counts the
admission day as a utilization day and completes Items 60
and 61, includes the day in Item 23, and makes a deductible
or coinsurance charge to the patient where applicable. Both
providers may bill for accommodation and ancillary charges.
This general rule applies to transfers between SNFs and
between a hospital and an SNF. However, under these same
circumstances, if the two providers represent an institution
composed of a participating hospital and a distinct part
participating SNF, the first provider cannot bill for
accommodations, but may bill for ancillary charges.
Page 5-12/Rev. 308
--------------------------------------------------------------------------------
03-92 BILLING PROCEDURES 517.9
Day of Discharge, Death, or Day Beginning a Leave of
Absence.--Generally, the day of discharge, death, or a day
on which a patient begins a leave of absence, is not counted
as a utilization day. (See ��242ff.) This is true even
where one of these events occurs on a patient�s first day
of entitlement or the first day of a provider�s
participation in the Medicare program. In both situations,
no payment can be made for accommodations for the day of
discharge, death, or day beginning a leave of absence, but
payment may be made for ancillary services provided. In
addition, a spell of illness begins whether the stay was in
a hospital or SNF. See �560, Item 15, Admission Date, and
Item 22, Statement Covers Period, for special instructions
pertaining to completion of Items 15 and 22 for these
situations.
The exception to the general rule of not charging a
utilization day for the day of discharge, death, or day
beginning a leave of absence is where the patient is
admitted with the expectation that he will remain overnight
but is discharged, dies, or is transferred to a
nonparticipating provider or a nonparticipating distinct
part of the same provider before midnight of the same day.
In these instances, such a day counts as a utilization day.
This exception includes the situation where the beneficiary
was admitted (with the exception that he would remain
overnight) on either the first day of his entitlement or the
provider�s first day of participation, and on the same day
he was discharged, died, or transferred to a
nonparticipating provider.
----- Original Message -----
From: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent: Tuesday, April 13, 2004 5:45 PM
Subject: Re: RENA
In a message dated 4/13/2004 7:35:25 PM Pacific Daylight
Time, [EMAIL PROTECTED] writes:
You can bill Medicare Part A for the day of discharge when
it is also the day of admission if the beneficiary was
discharged to a provider that does not participate in the
Medicare program. If the resident is discharged to a
Medicare-participating provider, such as an acute care
hospital, the SNF cannot bill for that day.
So there is NO POINT in doing a PPS assessment on a Part A
who admits to a facility and discharges to the acute the
same day. Correct??
If so, this point is very unclear to MANY members of this
listserv.
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