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Last Modified: 12/8/2017 Location: FL, PR, USVI Business: Part A

Rejection of claims with CC DR or modifier CR

Issue
Providers are reporting occurrence span code (OSC) 70 with a date range 30 days or more before the skilled nursing facility (SNF) admission date (receiving reason code 11503) on claims with condition code DR or modifier CR.
Resolution
Providers should not report OSC 70 on claims billed with CC DR or modifier CR. See 1135 waiver FAQ document external link SNF section, question 1135T-4.
Status/date resolved
Guidelines were established in 2011.
Provider action
Remove the OSC 70 when reporting CC DR or modifier CR.
Current processing issues
Here is a link to a table of current processing issues for both Part A and Part B.
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