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User Enhancement Change Request (UECR): Fiscal Intermediary Shared System (FISS) - Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) Reason Code 31849

The purpose of this UECR is to modify the SNF PDPM editing in FISS to be more efficient and prevent incorrect payments. Reason code 31849 will be modified to reduce unnecessary claim suspension and unneeded history retrieval requests. To reduce incorrect PDPM prior days calculation, a new reason code will be created to assign when the incoming claim should be billed as a new admission.

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: October 20, 2022

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.