CMS Pub. 100-04, ch. 3, § 60

Swing-bed services must be billed separately from inpatient hospital services. Swing-bed

hospitals use one provider number when billing for hospital services to identify hospital

swing-bed SNF bills. The following alpha letters identify hospital swing-bed SNF bills (for

CMS use only, effective May 23, 2007, providers are required to submit only their NPI.

NOTE: The swing-bed NPI will be mapped to the 6-digit alpha-numeric CMS Certification

Number (CCN.)

"U" = short-term/acute care hospital swing-bed;

"W" = long-term hospital swing-bed;

"Y" = rehabilitation hospital swing-bed; and

”Z”=CAH swing-bed.

Note that CAHs are exempt from the SNF PPS and instead are paid based on 101 percent of

reasonable cost for swing-bed services. CAHs are subject to the hospital bundling

requirements at section 1862(a)(14) of the Social Security Act and 42 CFR § 411.15(m), and

therefore, all services provided to a CAH swing-bed patient must be included on the CAH

swing-bed bill (subject to the exceptions at 42 CFR § 411.15(m)(3)). Certified registered

nurse anesthetist services paid on a pass-through basis are also to be included on the CAH

swing-bed bill.

A. - Inpatient Hospital Services in a Swing-Bed

The patient status code of 03 is inserted on the claim when the beneficiary swings from acute

to SNF level of care. (This constitutes a discharge for purposes of Medicare payment for

inpatient hospital services under PPS.) The A/B MAC (A) indicates in the Statement Covers

Through Date the last day of care at the hospital level.

If the beneficiary is discharged from a Medicare swing-bed and remains in the hospital, there

is no need for a no-pay bill. However, if a beneficiary continues to receive care after

completing their stay in a SNF swing-bed, in a NF swing-bed, the hospital must submit

covered claims to Medicare.

B. - SNF Services in a Swing-Bed

Services are billed, in accordance with Chapter 25 with the following exceptions:

• The date of admission on the swing-bed SNF bill is the date the patient began to

receive SNF level of care services;

• State level agreements may call for varying types of bill coding Type of Bill. The

CMS does not perform edits on type of bill coding on bills with 8 in the 2nd digit

(bill classification), in FL 18 of the CWF inpatient record if the record is identified in

FL 1 as hospital or SNF. Therefore, the A/B MAC (A) accepts, with subsequent

conversion, any bill type agreed to at the State level to identify swing-bed billing, i.e.,

18X or 21X. It must be sure the record identification of CWF FL 1 is consistent with

the provider number shown.