You can bill Medicare and receive payment anytime a resident is admitted and discharged on the same day. We do it all the time. If they went to another Medicare participating facility it does not use a day of utilization, but they still pay the facility (it is considered a non-covered day with covered charges). Billing should put a '40' in form locator 24 on the UB92. The 40 tells MC the patient transferred to another facility before midnight on the day of admission. If they go home it is a utilization day and you do not use the 40. Either way you are paid.
>>> [EMAIL PROTECTED] 04/13/04 09:12PM >>> Not quite. 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. This is from the Medicare Claims Processing Manual, Chapter 6 - SNF Inpatient Part A Billing. It can be found at http://www.cms.hhs.gov/manuals/104_claims/clm104c06.pdf <<QUOTE 40.3.5 - Determine Utilization on Day of Discharge, Death, or Day Beginning a Leave of Absence (Rev. 1, 10-01-03) SNF-517.6.B, A3-3103.4 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 the Medicare Benefit Policy Manual, Chapter 3, "Duration of Covered Inpatient Services.") 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 addition, a benefit period may begin with a stay in a hospital or SNF, on that day. 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 expectation 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. >>END QUOTE Rena Rena R. Shephard, MHA, RN, FACDONA, RAC-C Chair, American Association of Nurse Assessment Coordinators [EMAIL PROTECTED] > Subj: RENA > Date: 4/12/2004 7:32:34 PM Pacific Daylight Time > From: [EMAIL PROTECTED] > Reply-to: [EMAIL PROTECTED] > To: [EMAIL PROTECTED] > Sent from the Internet > > > > In a message dated 4/12/2004 5:55:05 AM Pacific Daylight Time, > [EMAIL PROTECTED] writes: > > >> If the date of admission and date of discharge are the same, you may bill >> Medicare for that day. >> >> Nathan >> > > This is the final correct answer to this issue, isn't it RENA? > /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/
