32907

FISS Narrative
For all bill types except 83X: line item date of service must be a valid day and within the From and Thru Dates of the claim.

Exception: on skilled nursing facility (SNF) TOB 21X claims, the line item date of service will only be validated. The claim will bypass the portion which ensures the date is within the From and Thru dates.

  • On inpatient rehabilitation facility Prospective Payment System (IRF PPS) claims, the following instructions apply to the revenue code 0024 line:
    • If the patient status is not 30, the line item date of service (LIDOS), if present, must be on or after the statement cover to date on the claim (line item date of service is not required)
    • Effective for dates of service on or after January 1, 2011, occurrence code 50 is utilized for the assessment dates for inpatient rehabilitation facilities, skilled nursing facilities and swing beds. Service dates are no longer required on the revenue code line 0022 or 0024.

Explanation and suggestions:

  • All outpatient claims require line item dates of service for each line on the claim
  • Inpatient SNF claims must have an assessment reference date on the revenue line 0022, unless billing a default RUG
  • If filing an interim IRF bill, the LIDOS must be on/after the statement cover to date on the claim
  • Effective for dates of service on or after January 1, 2011, occurrence code 50 is utilized for the assessment dates for inpatient rehabilitation facilities, skilled nursing facilities, and swing beds
  • Service dates are no longer required on the revenue code line 0022 or 0024

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