Medicare Payments, Reimbursement, Billing Guidelines, Fees Schedules , Eligibility, Deductibles, Allowable, Procedure Codes , Phone Number, Denial, Address, Medicare Appeal, EOB, ICD, Appeal.
Medicare Guideline posts
- Home
- Finding Medicare fee schedule - HOw to Guide
- LCD and procedure to diagnosis lookup - How to Gui...
- Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline,
- Step by step Guide Medicare participation program
- Medicare Fee for Office Visit CPT Codes - CPT Code 99213, 99214, 99203
- Medicare revalidation FAQ
- Gastroenterology, Colonoscopy, Endoscopy Medicare CPT Code Fee
- Medicare claim address, phone numbers, payor id - revised list

Skilled Nursing Facilities - Revenue code 0551, 0552
Revenue Codes
• Skilled Nursing
o 0551 – visit charge
o 0552 - hourly
• Indicate “21X”, “22X” or “23X” in type of bill field, which is field 4 for paper claims.
o First digit – Type of facility (2)
o Second digit – Bill classification (inpatient - 1, inpatient Medicare B only - 2 or outpatient - 3)
o Third digit – Frequency (e.g., admit thru discharge claim, etc.)
• Hospital Swing Bed claims should be billed with the “18X” type of bill and the taxonomy code for the hospital’s swing bed unit.
• For Florida Blue and BlueOptions members, provide the authorization/certification number on the claim. Plan of treatment should not be submitted with claim, unless requested.
• Submit room and board units to reflect the length of stay minus one unit for the discharge day. Day of discharge or death is not considered a covered day, unless admitted and discharged/deceased on the same day. For example, if a claim is submitted for dates of service 8/1/2014 to 8/7/2014, then the room and board units should be 6 to exclude the day of discharge or death.
• Refer to contractual reimbursement terms to determine if billing is based on Skilled Nursing Facility (SNF) revenue codes or HIPPS RUG codes. Typically only Medicare Advantage provider contracts are negotiated based on the inpatient prospective payment system for SNFs.
• Florida Blue requires SNF claims are submitted with the 191-194 or 199 revenue codes that represent sub-acute care. Any inpatient SNF claims for Non-BlueMedicare members that do not contain these specific room and board codes will be returned to the provider for appropriate billing.
Labels:
Medicare basic concept,
SNF
Subscribe to:
Post Comments (Atom)
Top Medicare billing tips
-
CPT CODE and Description 90785 - Interactive complexity (List separately in addition to the code for primary procedure) 90791 - Psychi...
-
This post has Most used J code list and we are constantly updating with example . If you are looking particular J code, use search button. ...
-
CPT code 99201: Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components...
-
Procedure code and description 93000 - Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report -average fee...
-
Procedure code and description 95806 - Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory air...
-
CPT CODES and Description 81000 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitr...
-
procedure code and description 71250 - Ct thorax w/o dye - average fee payment - $180 - $190 71275 CTA chest (noncoronary) 71260 CT ...
-
Procedure Codes and Definitions 36415 Collection of venous blood by venipuncture - Fee schedule amount $3.10 36416 Collection of capi...
-
Procedure code and description 72148 - MRI lumbar spine w/o dye - average fee payment - $230 - $240 72141 - Mri neck spine w/o dye -...
-
Procedure code and description 93015 (cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous ele...

No comments:
Post a Comment