Re: Local Codes/Code Sets

[Joanne Becker]

Title: Message

A follow-up question in regards to local codes ...   As mentioned, local codes cannot be used on a HIPAA transaction for payment, but can payers still require them in "situational" fields?   Thank you   Joanne Becker, RHIT, CCS JMB Consulting ----- Original Message ----- From: Ratayski, Dawn To: 'Singh, Arvinder' ; Ratayski, Dawn ; [EMAIL PROTECTED] Cc: '[EMAIL PROTECTED]' Sent: Tuesday, August 20, 2002 11:50 AM Subject: RE: Local Codes/Code Sets You are correct. Proprietary codes  can be used for services rendered prior to 10/16/02 (or) 03 if you took the extension.     -----Original Message----- From: Singh, Arvinder [mailto:[EMAIL PROTECTED]] Sent: Tuesday, August 20, 2002 12:44 PM To: Ratayski, Dawn; [EMAIL PROTECTED] Cc: '[EMAIL PROTECTED]' Subject: RE: Local Codes/Code Sets Dawn, Just a quick clarification. As I understand that the local codes are allowed for DOS prior to the HIPAA implementation date i.e 10/16/2003. So any DOS prior to this date can contain local codes. regards       Arvinder Singh Enterprise Solutions Division Client Network Services Inc. www.cns-inc.com [EMAIL PROTECTED] 301-944-2037   -----Original Message----- From: Ratayski, Dawn [mailto:[EMAIL PROTECTED]] Sent: Tuesday, August 20, 2002 10:41 AM To: [EMAIL PROTECTED] Cc: '[EMAIL PROTECTED]' Subject: RE: Local Codes/Code Sets Carol,   Please see my responses below. If I can be of further assistance, please let me know.   Sincerely,   Dawn Ratayski HIPAA Code Set Lead/TCI Developer BC of NEPA   -----Original Message----- From: Carol.Krause [mailto:[EMAIL PROTECTED]] Sent: Tuesday, August 20, 2002 10:10 AM To: [EMAIL PROTECTED] Subject: Local Codes/Code Sets In working with our System Set-Up and Claims Department on the 835 transaction, they have asked me some questions which I am unsure how to answer and am looking for input from the group. 1.      Are we required to accept diagnosis codes to the highest level of specificity?          ICD9 diagnosis codes must represent the highest level of specificity.   2.      Can we continue to use local codes to make payment to a provider (i.e., hospital contract paid on per diem or case rate methodology - we return an internal code outlining per diem/case rate payment).  These are not apparently the same as the Remittance Advice Remark Codes, which I do understand we have to map from local codes to HIPAA acceptable codes. You can not use local or proprietary coding to make payments on HIPAA transactions. You can allow an invalid code to remain on the transaction if you are denying it for it's validity.   3.      What provider types, if any, are exempt? I have seen indications the DME, Home Infusion, Alternative Healthcare Procedures and Dental Diagnosis are either unavailable or incomplete. And, I remember some conversation early on about Ambulance services and Social Work. There are no provider exemptions.   Any thoughts are appreciated. Carol F. Krause Business Analyst Health Alliance Medical Plans (217) 383-8182 [EMAIL PROTECTED] This electronic message contains information from Health Alliance Medical Plans , Inc. that may be confidential and/or privileged.   This information is intended to be for the use of the individual(s) or entity(ies) named above.  If you are not the intended recipient, be aware that copying, disclosure or distribution is strictly prohibited. If you have received this electronic transmission in error, please notify us by telephone at 800-851-3378 x.8012 or 4684 or by electronic mail to the sender immediately.  To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=codeset and enter your email address. The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited. To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=codeset and enter your email address. The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited. To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=codeset and enter your email address. The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited. To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=codeset and enter your email address. The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.