Same Day Transfer

40.3.3 - Same Day Transfer (Rev. 4001, Issued: 03-16-18, Effective: 06-19-18, Implementation: 06-19-18) The day of admission counts as a utilization day, except in the situation where the patient was admitted with the expectation that he remain overnight but was transferred to another participating provider before the following midnight. In this instance, the first provider completes the bill as follows: • Indicate “0” in Covered Days; • Insert condition code “40” to indicate the patient was transferred from one participating provider to another before the midnight immediately following the admission to the first provider; and, • Admission date, statement “from” and “through” dates are the same. No payment is made to the originating participating provider. Instead, the participating provider to which the patient was transferred counts the admission day as a utilization day that includes the day of admission and may bill the HIPPS default code. If a patient is transferred from a Medicare participating facility to a nonparticipating facility the day of admission counts as a utilization day and the Medicare-participating facility may bill the HIPPS default code. These general rules apply to transfers between SNFs and between a hospital and an SNF. However, under these same circumstances, if the two providers represent an institution composed of a participating hospital and a distinct part participating SNF, the first provider cannot bill for accommodations, but may bill for ancillary charges.