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Region

Region D

Issue Title

Skilled Nursing Facility Medical Necessity

Number

 

Description

Skilled Nursing Facility (SNF) stays will be reviewed for documentation of covered SNF services that are medically reasonable and necessary

States

AK, AZ, CA, HI, IA, ID, KS, MO, MT, ND, NV, OR,SD, UT, WA, WY, Guam, American Samoa and Northern Marianas

Provider Type

SNF

Date of Service

Claims having a claim paid date within three years of the ADR

References

CMS Publication 100-02 Chapter 8, Section 30 - 40 MDS 3.0 RAI Manual: CMS Publication 100-08 Chapter 6 §6.1 - 6.3 Social Security Act -1862A(1)a​

Date Posted

 

Date Revised

 

More Information

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Attachments

Created at 6/5/2013 10:08 AM by Aaron Gough
Last modified at 6/5/2013 10:36 AM by Aaron Gough