Medicare Manual Updates to Correct Errors and Omissions

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare®

On March 16, CMS posted updates to Medicare manuals “to correct various minor technical errors and omissions. Those changes are intended only to clarify the existing content and no policy, processing, or system changes are anticipated.” These updates are effective/being implemented as of June 19, 2018.

Providers submitting claims for services provided to Medicare beneficiaries should be aware of these manual updates. Be sure that your billing staff has access to the updates. The most efficient way to view these updates is through the MLN Matters – MM10512 publication. MM10512 provides basic information regarding the changes with links to the three (3) transmittals found on page 5.

The updates (shown in red on each transmittal) include:

  • Chapter 4 – Medicare General Information, Eligibility,
    and Entitlement Manual

    • Physician Certification and Recertification of Services
    • Certification for Extended Care Services
    • Transfer Agreements
    • Hospital Providers of Extended Care Services
  •  Chapter 8 – Medicare Benefit Policy Manual
    • Readmission to a SNF
    • Administrative Level of Care Presumption
    • Who May Sign the Certification or Recertification for Extended Care Services
    • Physical Therapy, Speech-Language Pathology, and Occupational Therapy Furnished by the Skilled Nursing Facility or by Others Under Arrangements with the Facility and Under Its Supervision
    • Respiratory Therapy
    • Services Furnished Under Arrangements with Providers
  • Chapter 1 – Medicare Claims Processing Manual
    • Charges to Hold a Bed During SNF Absence
    • Consolidated Billing Requirement for SNFs
    • Furnishing Services that are Subject to SNF Consolidated Billing Under an “Arrangement” With an Outside Entity
    • Other Excluded Services Beyond the Scope of a SNF Part A Benefit
    • Dialysis and Dialysis Related Services to a Beneficiary With ESRD
    • Other Services Excluded from SNF PPS and Consolidated Billing
    • Ambulance Services
    • Same Day Transfer
    • Situations that Require a Discharge or Leave of Absence
    • Determine Utilization on Day of Discharge, Death, or Day Beginning a Leave of Absence
    • Leave of Absence
  • Chapter 30 – Medicare Claims Processing Manual – Financial Liability Protections
    • Application of Limitation on Liability to SNF and Hospital Claims for Services Furnished in Noncertified or Inappropriately Certified Beds
    • Determining Liability for Services Furnished in a Noncertified SNF or Hospital Bed