CMS asks fiscal intermediaries to hold claims

CMS has told its fiscal intermediaries (FIs) to hold all inpatient hospital and long-term care claims, with discharge dates of Oct. 1 or later, until the release of its 2008 Pricer, which is scheduled for Oct. 15, 2007. This applies to all claims processed under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital Prospective Payment System (LTCH PPS). This guidance was communicated via CMS Joint Signature Memorandum 07548 (JSM-07548) on Sept. 28, 2007.

Effective Oct. 1, 2007, all hospital claims processed under the IPPS, with discharge dates on or after October 1, 2007, are being held in location S/MSPR1 with reason code 37150. All LTCH claims processed under the LTCH PPS, with discharge dates on or after Oct. 1, 2007, are being held in location S/MSPRL with reason code 37167. Once CMS notifies FIs to stop the temporary holding, the suspended claims will be released for payment.

This CMS directive does not affect claims processed under the inpatient psychiatric facility or the inpatient rehabilitation facility prospective payment systems.