Clarification for billing DMEPOS in SNF
Jeremy Sprouse
Description
Collection
Title:
Clarification for billing DMEPOS in SNF
Creator:
Jeremy Sprouse
Date:
11/16/2016
Text:
After reading an article in the Oct. 2016 O&P Almanac, I thought I was
missing the boat when billing for items delivered in a SNF.
The article states After 100 days of Medicare Part A SNF coverage within a
benefit period, Medicare Part A no longer covers the SNF stay. If the
patient remains in the SNF, he or she must pay for room, board and nursing
expenses through personal funds or other insurance. Medicare Part B will
cover any orthotic and prosthetic care that the patient needs. When this is
the case, you may submit your claim directly to the DME MAC for
consideration.
Please be advised this article is incorrect. While partially true, the SNF
must be considered their home, and the SNF must not provide primary skilled
nursing, or rehab. Please read the following CMS article for clarification.
<URL Redacted>
I bring this to attention since the OIG is planning on auditing claims for
patients who received DMEPOS while in a SNF.
<URL Redacted>
Please let me know if I am missing something here, I believe the O&P almanac
article to be incorrect, and may cause a financial burden to companies
providing DMEPOS while the patient is in a SNF.
Jeremy Sprouse CPO, BOCOP
Advanced Biomechanical Solutions
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missing the boat when billing for items delivered in a SNF.
The article states After 100 days of Medicare Part A SNF coverage within a
benefit period, Medicare Part A no longer covers the SNF stay. If the
patient remains in the SNF, he or she must pay for room, board and nursing
expenses through personal funds or other insurance. Medicare Part B will
cover any orthotic and prosthetic care that the patient needs. When this is
the case, you may submit your claim directly to the DME MAC for
consideration.
Please be advised this article is incorrect. While partially true, the SNF
must be considered their home, and the SNF must not provide primary skilled
nursing, or rehab. Please read the following CMS article for clarification.
<URL Redacted>
I bring this to attention since the OIG is planning on auditing claims for
patients who received DMEPOS while in a SNF.
<URL Redacted>
Please let me know if I am missing something here, I believe the O&P almanac
article to be incorrect, and may cause a financial burden to companies
providing DMEPOS while the patient is in a SNF.
Jeremy Sprouse CPO, BOCOP
Advanced Biomechanical Solutions
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
Citation
Jeremy Sprouse, “Clarification for billing DMEPOS in SNF,” Digital Resource Foundation for Orthotics and Prosthetics, accessed December 24, 2024, https://library.drfop.org/items/show/254391.
