Q:
How should situations, in which the 3-day qualifying hospital stay normally required for a covered Medicare admission to the SNF is waived due to the national emergency, be reported on the UB04 claim form?
A:
Providers that receive beneficiaries without a 3-day qualifying stay (and for whom the requirement was waived under section 1812(f)) should report condition code “DR” (disaster related) on their claim. Based on the presence of this code, Medicare systems will bypass the 3-day stay requirement and occurrence span code “70” (qualifying stay dates) need not be reported. In addition, providers should include remarks indicating “declared emergency/disaster” on their remarks page for tracking/verification purposes.
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Blog by Stacy Baker, OTR/L, CHC, RAC-CT, Proactive Medical Review
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