Re: Billing MBS under Cosolidated Billing

[Guest guest]

SNF Consolidated Billing applies to patients that are

in certified beds and covered under Part A at that

time. As far as I know, Part B Consolidated Billing is

still in suspended animation.

If a Part A SNF patient received MBS, I'm 99% sure all

charges must be sent to the SNF for billing. There is

a short list of exclusiong to consolidated billing,

but I don't remember MBS being one of them.

If the patient isn't covered by Part A at the time,

you don't have a problem.

Heier

Billing & Reimbursement Consultant

The Heier Power

--- bashuert wrote:

> My understanding of consolidated billing for SNFs is

> that all therapy

> services [for residents in both a covered (Part A)

> bed and in a non-

> covered (Part bed]must be billed TO THE SNF. My

> question has to

> do with billing for Modified Barium Swallow studies.

> It seems to me

> that if a SNF Resident comes to the hospital for a

> Modified, the

> hospital has to bill Medicare Part B directly for

> the Radiology

> portion of the procedure (HCPCS 74230?), but has to

> bill the SNF for

> the Speech Therapy portion of the procedure (G0196).

>

>

> I would greatly appreciate any additional insight if

> anyone has a

> different understanding. We are trying to do the

> right thing and I

> have a sheaf of CMS PM's I am reviewing, but am

> encountering

> differences of interpretation by various

> individuals. Thanks for your help.

>

> Bettyann Shuert, PT

> Director of Therapy Services for SNF & Rehab

> Outreach

> Health Systems, Springfield, MO

> ; fax 269-6820

> Bettyann.Shuert@...

>

>

__________________________________________________

[Guest guest]

I am not sure that I agree here. Every publication that I have read

from CMS regarding consolidated billing states that Consolidated

billing is on hold for part B (non-covered part A SNF residents) for

everyone EXCEPT OT, PT, and Speech.

This means to me that both part A and part B SNF residents who have a

MBS done at the hospital by a Speech Language Pathologist have to be

billed to the SNF... except for the part B resident where the

radiology charge can go to Medicare.

You are right... that the MBS is not excluded from PPS... and

therefore, the SNF is responsible.

I have spoken to several consultants on this and I feel comforatble

with the fact that we have to bill the SNF in both instances

(although I do not like it! :-)

Tina Rosier, PT

Compliance Team Leader

[Guest guest]

My understanding is that the WHOLE service is part of the consolidated

billing.

SO...the hospital should bill the SNF for the WHOLE procedures (Radiology &

ST).

Ellen R. Strunk, PT, MS, GCS

2245 Shelterwood Road

Birmingham, AL 35226

fax:

erstrunk@...