Field notes from the Burst billing floor, how supply reimbursement actually works, which mistakes cost SNFs the most, and the documentation that holds up under RAC review.
Showing 1–12 of 33 articles
When Part A ends, consolidated billing drops to therapy only and Part B supply billing opens. See which SNF supplies qualify and what each claim needs.
Medicare Part B pays SNFs for trach tubes, inner cannulas and daily care kits once a resident is off Part A. See the codes, the limits and what won't pay.
Medicare limits SNF Part B supply quantities 2 ways: LCD usual maximums and MUEs. See the 3 numbers to check on every claim before it goes out.
How SNFs bill Part B splints and orthotics under their own NPI: the braces benefit, the three L-code tiers, therapy documentation, and what audits find.
The five elements a SNF wound record must show for a surgical dressing claim: qualifying wound, dimensions, a signed order, dressing rationale, and evaluation.
How SNFs bill Medicare Part B urological supplies under their own NPI: the permanence criterion, catheter HCPCS codes, usual monthly maximums, and MDS Section H.
How SNFs bill Medicare Part B ostomy supplies under their own NPI: coverage rules, HCPCS pouch codes, monthly quantity limits, documentation, and what changes.
When a supplier bills for an SNF resident's covered item, the payment path depends on Medicare billing and consolidated-billing rules. Here is how to audit it.
Your SNF may lack visibility into Part B supply claims and payments. Use this five-step audit to review the contract, documentation, and Medicare rules.
Six metrics that show whether supported Part B supply claim opportunities are being captured, paid, denied, and reconciled in your facility.
How to read CARC and RARC codes on SNF Medicare Part B supply denials, which denials are appealable, and what the patterns say about your workflow.
SNFs have 12 months to file Part B supply claims that were never submitted. Under 42 CFR 424.44, what qualifies and how to run the lookback.