Medicare Compliance & Reimbursement

Skilled nursing facilities puzzled over Medicare policy for bill types 22x and 23x can take some guidance from a May 9 program memorandum from the Centers for Medicare & Medicaid Services (A-03-040; http://cms.hhs.gov/manuals/pm_trans/A03040.pdf). In the memo, CMS clarifies that bill type 23x should be used for beneficiaries who are placed in a Medicare non-certified part of the facility, while bill type 22x applies for residents who are in non-covered stays but are placed in the Medicare-certified section of the SNF. Bill type 22x is subject to consolidated billing; bill type 23x is not. In other recent program memoranda CMS:
changes the implementation date for certain policies relating to the processing of non-covered charges (A-03-039; http://cms.hhs.gov/manuals/pm_trans/A03039.pdf);
spells out coding issues connected with ambulance services that are affected by skilled nursing facility consolidated billing rules (B-03-039; http://cms.hhs.gov/manuals/pm_trans/B03039.pdf);
issues the July quarterly update to the durable medical equipment, prosthetics, orthotics and supplies fee schedule (AB-03-071; http://cms.hhs.gov/manuals/pm_trans/AB03071.pdf); schedules release dates to Medicare contractors on certain CMS software and pricing updates (AB-03-065; http://cms.hhs.gov/manuals/pm_trans/AB03065.pdf);
announces the posting of the second update to the 2003 Medicare physician fee schedule database (AB-03-070; http://cms.hhs.gov/manuals/pm_trans/AB03070.pdf);
revises policies on contractors' appeals quality improvement and data analysis activities (AB-03-067; http://cms.hhs.gov/manuals/pm_trans/AB03067.pdf);
updates contractor coordination-of-benefits procedures (AB-03-066; http://cms.hhs.gov/manuals/pm_trans/AB03066.pdf);
addresses certain Health Insurance Portability and Accountability Act transaction standards concerns (AB-03-068; http://cms.hhs.gov/manuals/pm_trans/AB03068.pdf);
clarifies rules on statements of intent to file a Medicare claim (AB-03-069; http://cms.hhs.gov/manuals/pm_trans/AB03069.pdf).