Skilled Nursing Facility (SNF) Claims Processing Updates

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

On Thursday, November 4, 2021, CMS posted Transmittal 11109 … Change Request 12344. This 10-page transmittal “updates SNF edits to bypass services related to an emergency room encounter and there is also a 250 revenue code present on the same claim. This CR also make updates to certain FISS and CWF edits for overlapping claims when there is a no-pay hospital claim during an interrupted stay.”

Look for the red in on pages 6 through 10 within the Transmittal.