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 CodeMap Compliance Briefing: 8/27/04


 

Editor's Welcome

The rules for how to bill services for nursing home residents are complicated and confusing, especially for clinical laboratories and other Part B providers who have to determine when to bill the nursing home and when to bill Medicare Carriers directly. In this week's briefing we will try to clarify Medicare's consolidated billing rules for Skilled Nursing Facilities (SNFs) as they apply to diagnostic service providers and the related exceptions. Next week, there will be no CodeMap Compliance Briefing in observance of Labor Day. As always, please feel free to email your comments and questions.

Sincerely,

Charles B. Root, Ph.D.

Background

Nursing home residents are covered by Medicare Part A during the initial 90 days after hospital discharge. The nursing home receives a daily payment based on the severity of the resident's condition that covers most services. After the initial Part A coverage period, Medicare....

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