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Medicare Stay.

MDS   (330 Views | 3 Replies)

472 Profile Views; 23 Posts

Hello,

Patient  Medicare Part A  admitted on 05/18/2020 at 11:11 and discharged on 05/19/2020 at 12:00 do I need to open the 5 day assessment or just entry  and discharge?

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Talino specializes in ER CCU MICU SICU LTC/SNF.

970 Posts; 16,298 Profile Views

Day of stay ends at 11:59 pm and begins at 12:00 am. Get paid for 5/18. Combine the 5D and DC ARD 5/19.

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23 Posts; 472 Profile Views

1 hour ago, Talino said:

Day of stay ends at 11:59 pm and begins at 12:00 am. Get paid for 5/18. Combine the 5D and DC ARD 5/19.

Thank you for the response. That's exactly what I did, however, I have been told that we don't bill Medicare for the discharge day and if the patient was in the facility for less than 24 hours its failure to admit.

 

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Talino specializes in ER CCU MICU SICU LTC/SNF.

970 Posts; 16,298 Profile Views

Correct, you don't get paid for the day of discharge 5/19. The day of admission 5/18 is considered a utlization day, regardless the number of hours in the SNF.

In fact, if a resident is admitted @ 11 am and decides to go home @ 1 pm on the same, the day still counts as a utilization day.

Medicare Claims Processing Manual Chapter 6 - SNF Inpatient Part A Billinghttps://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c06.pdf

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