Tip of the week: Know the consolidated billing major categories of exclusion
Contemporary Long-Term Care Weekly, January 7, 2010
It’s important for administrators to have some working knowledge of services that are excluded from consolidated billing. These are services that are excluded from Medicare Part A bundling and often can be covered under Medicare Part B. The Centers for Medicare & Medicaid Services has divided the exclusionary codes into five major categories:
- Category I: Exclusion of services beyond the scope of a SNF
- Category II: Additional services excluded when rendered to specific beneficiaries
- Category III: Additional excluded services rendered by certified providers
- Category IV: Additional excluded preventive and screening services
- Category V: Part B services included in SNF consolidated billing
This is an excerpt from HCPro’s book, The Long-Term Care Administrator’s Field Guide, by Brian Garavaglia, PhD.
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