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Outpatient Therapy Services for Skilled Nursing – Revenue code 0420, 0430

by Medical Billing | Nov 6, 2016 | Medicare payment basics

Can I appeal an outpatient therapy threshold prior authorization decision? Answer: When a service provided beyond the thresholds is determined to be not medically necessary through prior authorization and/or pre-payment review of the claim, it is denied as a benefit...

Skilled Nursing Facilities – Revenue code 0551, 0552

by Medical Billing | Oct 26, 2016 | Medicare payment basics

Revenue Codes • Skilled Nursing o 0551 – visit charge o 0552 – hourly • Indicate “21X”, “22X” or “23X” in type of bill field, which is field 4 for paper claims. o First digit – Type of facility (2) o Second digit – Bill classification (inpatient – 1,...

Inpatient Care in SNF – Revenue code 0191 – 0194

by Medical Billing | Jul 13, 2016 | Medicare payment basics

Type of bill (211-214) Revenue code (0191-0194, 0199) • Level 1 (Revenue Code 0191) • Level 2 (Revenue Code 0192) • Level 3 (Revenue Code 0193) • Level 4 (Revenue Code 0194) • Level 5 (Revenue Code 0199) • All per diem rates will include, but may not be limited to the...

Skilled Nursing Facility Coverage Requirements and Benefit Period

by Lori | Aug 26, 2015 | Medicare payment basics

To qualify for Medicare Part A coverage of SNF services, the following conditions must be met: ◘ The beneficiary was an inpatient of a hospital for a medically necessary stay of at least 3 consecutive days; ◘ The beneficiary transferred to a participating SNF within...

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CPT Codes, Descriptors, and other data only are copyright 1999 American Medical Association (or such other date of publication of CPT). All Rights Reserved to AMA.
The revenue codes and UB-04 codes are the IP of the American Hospital Association. All Rights Reserved to AMA.
All our content are education purpose only. All the articles are getting from various resources. If you find anything not as per policy. Please reach out and we would do the investigation and remove the article.
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