Following the recent CMS Administrator’s Ruling CMS-1455-R, CMS issued a Program Transmittal with claims processing instructions related to the rebilling of denied inpatient claims under the interim rebilling policy. A corresponding article intended for hospitals was released on March 22, 2013 and can be found on the CMS website here.
The article contains important information for coding and submission of claims, including timing, bill types, condition codes, treatment authorization codes and required remarks. Further, the article makes clear that hospitals may also bill separately for outpatient services provided in the three-day (or one-day) payment window and that rebilling of denied inpatient claims will not impact skilled nursing facility eligibility. Finally, hospitals submitting Part B inpatient claims during the interim rebilling policy are acknowledging that the Part B claim is a duplicate of a denied Part A claim, that no payment will be made for items and services included on the Part A claim and that any amounts collected from the beneficiary for the Part A claim will be refunded to the beneficiary. CMS will establish permanent policy changes through notice and comment rulemaking. The associated Proposed Rule was published in the Federal Register on March 18, 2013, and comments are due by 5 P.M. on May 17, 2013.
If you have any questions related to the interim Part B rebilling policy or instructions, please contact Regan E. Tankersley at 317-977-1445 or rtankersley@wp.hallrender.com.
