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 legacy
(OSCAR) number.):
"U" = short-term/acute care hospital swing-bed;
"W" = long-term hospital swing-bed;
"Y" = rehabilitation hospital swing-bed; and
”Z”=CAH swing-bed.
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
• 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.
