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Billing and Processing Issues - P&NP Computer

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Billing Issues1February 2001Billing and Processing IssuesIdentified Billing Errors - Provider Education NeedsModifiers New Additions and Appropriate UseBilling for 5 Day PresumptionSpecial Billing Situations:Leave of AbsenceHMODemand BillsAdjustmentsIdentified Processing ProblemsBilling Issues2February 2001Identified Billing ProblemsMedical review workgroup discussions identified frequent Billing errors in SNFPPS claim submissions. These errors are common across the country and speakto the need for additional provider Reference Date (ARD)The ARD marks the end of the look back period. It must be set within thewindow of days allowed by the Medicare MDS assessment schedule.

Billing Issues 3 February 2001 Number of Days in the Payment Block The SNF PPS schedule establishes the maximum number of days that can be billed per each assessment.

  Assessment, Billing

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