CMS Pub. 100-04, ch. 3, § 190.16

FISS shall ensure that:

• Revenue Code total charges line 0001 must equal the sum of the individual total

charges lines.

• The length of stay in the statement covers period, from and through dates, equals

the total days for accommodations Revenue Codes 010x-021x, including Revenue

Code 018x (leave of absence)/interrupted stay.

• Value Code 75 is allowed from contractor entry and not allowed from Provider

entry. Also, Providers are not allowed to alter this information.

• The ED adjustment is not made where a patient is discharged from an acute care

hospital or CAH and admitted to the same hospital’s or CAH’s psychiatric unit

with the application of the correct Point of Origin code “D” on the IPF PPS claim.

FISS and CWF shall ensure that multiple Occurrence Span Code 74s are allowed.

CWF shall ensure that:

• Occurrence Span Code 74 is present on the claim when there is an interrupted stay

(the beneficiary has returned to the same IPF within 3 days).

• Value Code 75 is present on claims when there is an interrupted stay resulting

from a discharge at another IPF (the beneficiary has returned to the different IPF

within 3 days).