Part B general billing requirements
Billing Alert for Long-Term Care, August 1, 2010
This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Billing Alert for Long-Term Care.
Bill types. Under Part B, there are two types of bills (TOB) which are reflected on the UB-04 Medicare claim form: 22X (inpatient) and 23X (outpatient). CMS has confirmed that the SNF should use TOB 22X for any inpatient, whether the person is in a Medicare-certified bed or a noncertified bed. Use TOB 23X only for patients who live in the community and receive outpatient services from your SNF. Code the TOB (22X or 23X) in form locator 4 of the UB-04.
Fee schedules. A fee schedule, also referred to as a fee screen, is a complete list of fees used by Medicare to pay doctors, providers, and suppliers. This comprehensive list of fee maximums is used to reimburse a nursing home or other providers on a fee-for-service basis. CMS develops fee schedules for physicians, ambulance services, clinical laboratory services, and durable medical equipment, prosthetics, orthotics, and supplies.
This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Billing Alert for Long-Term Care.
Related Products
-
Coding and Billing for Outpatient Rehab Made Easy:
Take the confusion out of coding and billing for outpatient rehab and ensure you receive accurate reimbursement for the...
-
ADL Coding and the Impact on Your Facility's Reimbursement
Don’t let improper ADL coding put your facility at risk of significant revenue loss. Join HCPro on Tuesday, June 19, at 1...
-
Therapy and Nursing Documentation: Maintaining Efficiency and Compliance
Proper documentation has never been more crucial under MDS 3.0, both in terms of therapy and nursing. During this 90-minute...
-
Revenue Cycle Digital Library - Reimbursement - Single User Access
A searchable, Web-based resource that provides online access to HCPro’s expertly developed Medicare reimbursement books and...
-
Billing Alert for Long-Term Care
It's essential to know how to correctly submit your Medicare claims in order to get the reimbursement your facility...
Most Popular
- Articles
-
- Practice the six rights of medication administration
- Don’t forget the three checks in medication administration
- Note similarities and differences between HCPCS, CPT® codes
- Complications from immobility by body system
- Q/A: Correctly determining billing units for drugs
- Note from the instructor: CMS issues guidance on hospital inpatient admission order and certification requirements, Part I: Physician certification
- Differentiate between types of wound debridement
- The program coordinator's role with the clinical competency committee
- What does case-mix index mean to you?
- Know guidelines and subtle differences in code descriptions for laceration repairs
- E-mailed
-
- Joint Commission now allows partially-used oxygen canisters in 'full' rack
- What is the difference between an IPA and a medical group?
- Understand which parts of the medical record coders can use
- Teamwork makes clinical documentation management program a success at Kettering Medical Center
- Initial vs. subsequent. New vs. established. Will it be an issue?
- Five keys to creating a CHF disease management program
- Do not append modifier -52 to procedures involving equipment failure
- Data gathering/reporting: One CDI specialist shares her hospital's methodology
- Communication strategies for nurse leaders
- CMS and Joint Commission clarify door-closing devices standards
- Searched