Critical Access Hospital Swing Bed Claims

CAH Swing Bed claims with dates of service October 1, 2019 or later were erroneously editing for SNF PDPM and advising the provider to split bill for SNF PDPM. The following temporary instructions are given in order to process CAH Swing Bed claims correctly. November 2019 the reason code 31864 was updated to suspend all CAH Swing Bed claims (TOB 18X with provider numbers in the range xxZ300-xxZ399).

Claims returned to provider (RTPd) prior to November 15, 2019 can PF9 or resubmit the claims. Providers should wait for any claims suspended for reason code 31864 to be released with each night's cycle. CMS anticipates a resolution in April 2020.

            Last Updated Tue, 24 Dec 2019 11:32:20 +0000