Medicare Stay.

Posted
by Liza22 Liza22 Member Nurse

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?

Talino

Talino

Specializes in ER CCU MICU SICU LTC/SNF. 1,010 Posts

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.

Liza22

Liza22

36 Posts

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.

Talino

Talino

Specializes in ER CCU MICU SICU LTC/SNF. 1,010 Posts

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