Patient Driven Payment Model: Claim Edit Enhancements - Revised

MLN Matters Number: MM12896 Revised
Related CR Release Date: February 24, 2023
Related CR Transmittal Number: R11879OTN
Related Change Request (CR) Number: CR 12896
Effective Date: Dates of service on or after October 1, 2019
Implementation Date: April 3, 2023

Note: CMS deleted references to occurrence span code 74 and the M1 condition code.

CR 12896 tells you about:

  • Corrections to edits of SNF Type of Bill (TOB) 21X claims
  • Changes to certain hospital overlap edits

Make sure your billing staff knows about these changes.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)12896.

Last Updated Mar 09 , 2023