HCPCS Codes Used for SNF CB Enforcement - October Quarterly Update to the 2019 Annual Update

MLN Matters Number: MM11381
Related CR Release Date: August 2, 2019
Related CR Transmittal Number: R4341CP
Related Change Request (CR) Number: 11381
Effective Date: October 1, 2019
Implementation Date: October 7, 2019

CR 11381 provides updates to the lists of HCPCS codes that are subject to the consolidated billing provision of the Skilled Nursing Facility (SNF) Prospective Payment System (PPS).

CR11381 alerts providers of incorrectly categorized CPT codes 29580, 29581, and 29584. CR 11381 provides instructions to categorize these codes correctly on the SNF Consolidated Billing (CB) files.

Section 1888 of the Social Security Act codifies SNF PPS and Consolidated Billing (CB). The new coding identified in each update describes the same services that are subject to SNF PPS payment by law. No additional services are in place because of these routine updates; that is, the new updates occur because of changes to the coding system, not because of redefined services subject to SNF CB. There are no other regulatory changes beyond code list updates.

Make sure your billing staffs are aware of these changes.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)11381.

Last Updated Aug 06, 2019