News, Skilled Nursing Facility

Frequently asked questions about Medicare Part B

Source: The Bottom Line

Q: How should multiple units of the same HCPCS code given on the same day be listed on the UB-04 (e.g., four units of 97530 in occupational therapy)?

A: Units of the same HCPCS code provided by the same discipline on the same day should be listed on the same line item. In the above example, it would be one line with four units of 97530, and the individual unit charge would be multiplied by four.

Q: Is it acceptable to take the ICD-10 codes from the face sheet or the hospital discharge paperwork?

A: No. The ICD-10 codes should always be reviewed by the clinician, therapist, or certified coder to ensure that they are the most accurate reflection of the reason the individual is receiving Part B services.

Q: Is an admission date required on a Part B claim?

A: Generally, no, you do not need an admission date for Part B. However, follow your MAC’s instructions if they differ.

Q: Can Medicare as Secondary Payer affect Part B claims?

A: Yes! Another insurance, such as an auto liability policy, can certainly be primary to traditional Medicare. Always screen for other payers.

Find more Q&As like this in the Medicare Guide for SNF Billing and Reimbursement.