Editing of Skilled Nursing Facilities Part B Inpatient Services

10.1.1 - Editing of Skilled Nursing Facilities Part B Inpatient Services (Rev. 3481, Issued: 03-18-16. Effective: 06-20-16, Implementation: 06-20-16) Medicare pays under Part B for physicians’ services and for non-physician medical and other health services listed below when furnished by a participating hospital to an inpatient of the SNF when patients are not eligible or entitled to Part A benefits or the patient has exhausted their Part A benefits. The SSM shall edit to prevent payment on Type of Bill 22x for claims containing the revenue codes listed in the table below. 010x 011x 012x 013x 014x 015x 016x 017x 018x 019x 020x 021x 022x 023x 024x 0250 0251 0252 0253 0256 0257 0258 0259 0261 0269 0270 0273 0277 0279 029x 0339 036x 0370 0374 041x 045x 0472 0479 049x 050x 051x 052x 053x 0541 0542 0543 0544 0546 0547 0548 0549 055x 057x 058x 059x 060x 0630 0631 0632 0633 0637 064x 065x 066x 067x 068x 072x 0762 078x 079x 093x 0940 0941 0943 0944 0945 0946 0947 0949 095x 0960 0961 0962 0969 097x 098x 099x 100x 210x 310x The contractor shall use the following remittance advice messages and associated codes when rejecting/denying claims under this policy. This CARC/RARC combination is compliant with CAQH CORE Business Scenario Three. Group Code: CO CARC: 96 RARC: M28 MSN: 21.21