I would call my FI. My intermediary
will pay in this situation and I do a 5 day PPS to get the RUGS score. I
originally called them because I found it hard to believe that we would be
expected to provide that level of care and not get paid. Let’s face
it, most residents who come and return to acute care same day are very ill and
get tons and tons of skilled care. Fortunately for me my intermediary
agrees even cited the regulation previously mentioned as proof. I can see
where it is a matter of interpretation by the intermediary so that is who I
would call.
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of MDSNancy
Sent: Thursday, April 15, 2004
8:02 AM
To: [EMAIL PROTECTED]
Subject: Re: NEED CLARIFICATION OF
OPPOSING OPINIONS
Oh boy! I'd like to know
too! Because I have been told that I have to do a PPS mds on a
resident admitted then discharged on the same day. I'm in a SNF and
usually these residents are admitted then sent back to the hospital.
Thanks
[EMAIL PROTECTED]
wrote:
I'm sorry, but I won't let this go.
Please read both messages below and let me know what
the final ruling is.
I alone have 99 residents and frequently do PPS
assessments on residents who are admitted and transferred to acute the same
day. Judging by Rena's response, I am wasting my time. According to the other
writer, I am not.
This is a big issue for me!
In a message dated 4/14/2004 6:27:35 AM Pacific
Daylight Time, [EMAIL PROTECTED] writes:
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.
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