Submitting Inpatient Part A No Pay Bills
In order to expedite the processing of inpatient Part A no pay bill(s); please follow the guidelines below:
- Use a condition code 20 when the beneficiary has requested a demand bill. (SNF's only)
- Use a condition code 21 when you have determined the patient is no longer receiving a skilled level of care or the service is excluded from Medicare coverage and you need a denial from Medicare in order to bill another insurance.
- Prior to Admit Date of October 1, 2006 if you are submitting the no pay bill due to the Medicare benefits exhausted, no qualifying hospital stay or the thirty day transfer requirement was not met, please enter verbatim the following remarks on page 4 of your claim:
- "Benefits exhau" for benefits exhausted
- "No QHS" (for no qualifying hospital stay, this applies to SNF's only)
- "No 30 day tran" (for no 30 day transfer, this applies to SNF's only)
- If the claim does not have any of the criteria indicated above, it will be returned to you, (RTP'd).
Page Last Updated: Tuesday, 15-Jul-2008 10:35:46 CDT
