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I have
been trying to get this clarified for over a year. Some FIs allow you to
bill while others dont. Doesnt make much sense.
Ron
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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