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Cheatography

Skilled Nursing Facility Consolidated Billing Cheat Sheet (DRAFT) by [deleted]

SNF Patients Who to Bill - Medicare

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Introd­uction

Skilled Nursing Facility (SNF) Consol­idated Billing (CB) Who to Bill Quick Reference

Situations

Situat­ion
Part A
Part B
SNF
Patient transport to the SNF for initial admit. (All qualifying SNF criteria are met)
Patient has a CT Scan at a hospital or CAH² during a SNF stay.
Patient has a cardiac cather­ization at a hospital or CAH during a SNF stay.
Patient has an MRI at hospital or CAH during a SNF stay.
Patient receives Radiation Therapy at hospital or CAH during a SNF stay.
Patient receives an Angiog­raphy, Lymphatic, Venous and Related Procedures at hospital or CAH during a SNF stay.
Patient transp­orted to a hospital ER during a SNF stay.
  
Patient receives a CT Scan at a freest­anding diagnostic facility or provider's office during a SNF stay.
  
Patient is receives cardiac cather­ization at a freest­anding facility or provider's office during a SNF stay.
  
Patient is receives an MRI at a freest­anding facility or provider's office during a SNF stay.
  
Patient is receiving Radiation Therapy at a freest­anding facility or provider's office during a SNF stay.
  
Patient is receiving Angiog­raphy, Lymphatic, Venous and Related Procedures at a freest­anding facility or provider's office for during a SNF stay.
  
Patient is being transp­orted to a free standing ER during a SNF stay.
  
A surgical or related procedure during a SNF stay. View the list on the website provided. Most surgeries are excluded from SNF CB, but a small list is included. Found in the FI/A/B MAC Update file category 1 subcat­egory F.
  
Patient is receiving Occupa­tional Therapy during a SNF Stay.
  
Patient is receiving Physical Therapy during a SNF Stay.
  
Patient receiving Speech Language Pathology Services during a SNF Stay.
  
Patient is receiving services from a social worker during a SNF stay.
  
Patient is receiving Preventive and Screening Services during a SNF Stay. (Mammo­graphy, Vaccines (Pneum­oco­ccal, Flu or Hepatitis B), Vaccine Admini­str­ation, Screening Pap Smear and Pelvic Exams, Colorectal Screening Services, Prostate Cancer Screening, Glaucoma Screening, Diabetic Screening, Cardio­vas­cular Screening, Initial Preventive Physical Exam (IPPE), Abdominal Aortic Aneurysms (AAA) Screening.
Patient is receiving Chemot­herapy or Admini­str­ation during a SNF Stay.
Patient is receiving Radioi­sotopes or their Admini­str­ation during a SNF Stay.
Patient is receiving servicers related to a Custom Prosthetic Device related services during a SNF Stay.
For a SNF to SNF transfer.
 
Patient is being transp­orted to a doctor's office for a physician visit during a SNF Stay.