I hope this doesn't spawn any additional tirades. I was up on most of this stuff in its earlier days, got away from it for a time and am trying to get back up to speed. I know this has probably been addressed ad-nauseum by the group, but can't find anything in the EDI-L Archives. It relates to recent discussions about the differences in related IG's. In the HIPAA 270 [Benefit Inquiry], There is a situational element allowing for use of industry standard Type Of Service (TOS) codes. (270·2110D·EQ01-1365 Service Type Code) Note: This element exists in the 271 [Benefit Response] IG as well. Use of this code helps further define a proposed/provided medical service. Example: [12]Durable Medical Equipment Purchase vs: [18]Durable Medical Equipment Rental (Two very different things) This item was removed from the final version of all three 837 IG's. So... The provider can query for and receive benefit information specific to service type, but can't report the service (by type) when they bill it. Were looking at performing a lot of basket weaving to try and determine the service type using Procedure Code, Modifier, Place of Service, Provider Taxonomy, etc. Has anyone come up with a better plan? Am I missing an element in the 837's which covers this? ÝÝÝÝÝÝÝÝÝÝÝÝÝÝÝÝÝÝÝÝÝÝÝØ contact the list owner: mailto:[EMAIL PROTECTED] Archives at http://www.mail-archive.com/edi-l%40listserv.ucop.edu/
