Q: I have a question about navigating the skilled nursing facility (SNF) benefit for Medicare. My understanding is that you can only use a Hospital-Issued Notices of Noncoverage (HINN) for inpatient, so you could use if less than a three-day stay. We have been giving Advance Beneficiary Notices (ABN) for our traditional Medicare patients that are observation when families are not timely on getting a SNF secured to those patients that require it. Is this correct?
Q: We provide tobacco cessation services and have been reporting these with time-based HCPCS codes. There are also CPT® codes for these services. Which is the appropriate set of codes to use for Medicare?
Q: In my facility, we are supposed to send an email to our physician advisor (PA) and to administration if a query is not answered within a week. However, this policy doesn’t work well because administration does not do anything with that information, and the PA doesn’t have time to review unanswered queries. Do you have any suggestions concerning when to let a query go unanswered?
I was under the impression that CMS said it would leave the billing for self-administered drugs to the OIG. However, we have not heard anything from the OIG. What if we are not billing for the medications?
The August 2 issue of Revenue Cycle Daily Advisor included a question about benchmark conversion rates from observation to inpatient status. With regard to that question, I think it may be helpful to know the average national conversion rate and average rate for critical access hospitals. Do you have that information?
