Patient Readmitted Within 30 Days After Discharge

40.3.2 - Patient Readmitted Within 30 Days After Discharge (Rev. 10569, Issued: 01-14-21, Effective: 04-01-21, Implementation: 04-05-21) A patient is deemed not to have been discharged if the time between SNF discharge and readmission to the same or another SNF is within 30 days. (See the Medicare Benefit Policy Manual, Chapter 8, “Coverage of Extended Care Services (SNF) Under Hospital Insurance,” §20.2.) However, if more than 30 days elapse after the patient’s discharge from a participating SNF or after his/her transfer to a nonparticipating part of the institution, the patient must again meet the 3-day hospital stay requirement to become eligible for SNF benefits. When a discharge bill has been sent and the patient is readmitted to the SNF within 30 days, the SNF must submit another bill, which shows the current admission date and the following additional data. • The SNF must complete condition code “57” on the claim to indicate the patient previously received Medicare covered SNF care within 30 days of the current SNF admission. • The SNF must complete occurrence span code “70” to indicate the qualifying stay dates for a hospital stay of at least 3 days which qualifies the patient for payment of the SNF level of care services billed on the claim. If a discharge bill has not been sent at the time of readmission, the SNF must submit an interim bill with occurrence code “74” to show the from/through dates of the leave of absence (the period the patient was not in the facility) and the number of noncovered days. For claims that contain both covered days and noncovered days, and those noncovered days are the responsibility of the beneficiary (e.g., days submitted for noncovered level of care), the provider should append span code 76 to indicate the days the beneficiary is liable.