CMS Pub. 100-04, ch. 3, § 40.2.6

Providers submit one bill for covered days and days of leave when the patient is ultimately

discharged.

The provider bills for covered days with days of leave included in Noncovered Days.

Noncovered charges for leave of absence days (holding a bed) may be omitted from the bill

or may be shown under revenue code 018x. Providers will be instructed by their A/B MAC

(A) on which billing method to use. Occurrence span code 74 is used to report the dates the

leave began and ended. Although the Medicare program may not be billed for days of leave,

the provider is not permitted to charge a beneficiary for them.

Where a patient on leave of absence from a non-PPS hospital who was shown as "Still

Patient" (patient status code 30) on an interim bill:

• Has not returned within 60 days, including the day leave began, or

• Has been admitted to another institution at any time during the leave of absence,

submit an adjusted bill.

The hospital shows the day the patient left the hospital as the date of discharge. (A

beneficiary cannot be an inpatient of two institutions at the same time.)

NOTE: Home health or outpatient services provided during a leave of absence do not affect

the leave and no discharge bill is required unless the above events occur.