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CodeMap Compliance Briefing: 01/14/05


 

Editor's Welcome

Several months ago (CodeMap Compliance Briefing: 08/27/04) we discussed Medicare's consolidated billing requirements for Skilled Nursing Facilities (SNFs) including how to bill for laboratory and other diagnostic services. CMS has recently further clarified the SNF consolidated billing rules in the Fiscal Intermediary Manual and commented in more detail on how SNFs and outside providers should structure arrangements to provide these tests and services. Today we will examine these arrangements and the associated compliance issues.

Sincerely,

Charles Root, Ph.D.

Providing Services "Under Arrangement" to Nursing Homes

The consolidated billing rules of Medicare require SNFs to bill Medicare directly for many services performed for SNF residents. The Part A consolidated billing rules require SNFs to bill Medicare for most services, including laboratory tests and the technical component of radiology and pathology services, pe....

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