Module-1: Introduction to Skilled Nursing Facilities (SNFs)

SNF in medical coding stands for Skilled Nursing Facility, a licensed healthcare setting that provides short-term skilled nursing care and rehabilitation services to patients recovering from hospitalization, illness, injury, or surgery.

A SNF is a facility or part of a facility engaged in providing skilled nursing care and related services. The patients require medical or nursing care or rehabilitation services. The rehabilitation services are for patients that are: 

• Injured
• Disabled
• Sick 

Special care center for patients needing temporary rehab (like PT/OT/Speech) after a hospital stay, where coders use specific codes (ICD-10, CPT) and models like PDPM (Patient-Driven Payment Model) for complex billing, especially for Medicare Part A, focusing on services by skilled nurses/therapists. 

Module-2: SNF Coverage and Reimbursement

Medicare provides specific rules for Skilled Nursing Facility (SNF) coverage under Part A. Understanding these rules is essential for correct ICD 10 CM coding, PDPM assignment, billing accuracy, and compliance. Coders must know when a service qualifies for Part A payment and how documentation supports each element of coverage.

Module-3: SNF - Consolidated Billing CB

Understanding Bundled Payments for Skilled Nursing Facility SNF Patients

Consolidated Billing CB is a fundamental part of the Medicare Part A payment system for Skilled Nursing Facilities. Under the SNF Prospective Payment System PPS, Medicare provides a single bundled payment that covers most services a resident receives during a Part A covered SNF stay. This means the SNF is financially responsible for almost all services delivered to the patient, even when those services are performed by outside providers.

Providers or suppliers must:

• Verify patient Part A or B status and SNF status before providing services
• Not submit a separate Part B bill to Medicare Administrative Contractors (MACs) for services subject to CB
• Look to the SNF for service payments subject to CB
• Inform all patients who get services in a covered Part A stay about CB requirements

Module-4: SNF ICD-10-CM Coding

Primary Diagnosis Coding and Comorbidity Optimization

Accurate diagnosis coding is the foundation of Skilled Nursing Facility reimbursement under PDPM. Coders must understand how ICD 10 CM codes map to PDPM clinical categories, influence case mix components, and support MDS accuracy. This module trains coders to correctly identify the primary diagnosis for a SNF stay and capture all medically relevant comorbidities that impact Nursing, SLP, and NTA scoring.