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We worked with our Meditech consultant and she came up with an easy
solution as long as you use specific locations for "non-patints". You
leave the TOB 141 in place and add TOB D2 as below (pre published KB
article) with a Map for the non patient locations.
We tested this and it works great. Sometimes there is a simple
solution! The only caution is that you must use specific locations that
are always TOB 141 patients which we have always done anyway.
Bob Ickes, MS
Meditech Analyst
St. Mary's Hospital
2635 N. 7th Street
Grand Junction, CO 81502
(970) 244-7647 Fax(970) 244-2857
[EMAIL PROTECTED]
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--------------------------------------------------------
Article ID: 23899
Enter Date: 2/22/2006
Publish Date: 2/22/2006
Author: CCONVENT/MBEYER
Application: BAR
Subject: ALL
Platform: ALL
Status: PUBLISHED
Title: TOB 141 CHANGE FOR NON-PATIENT LAB SPECIMENS - EFFECTIVE 4/3/06
Description
-----------------------------------------------------
Effective 4/3/06, CMS has changed the criteria for a 141 type of bill.
Currently, hospitals can use the TOB 141 field and map this to
applicable rev codes; however, the new criteria appears to be based off
of Location of non-patient (for example, patient from rural health
clinic, home health agency, individuals home or physicians office) lab
specimens.
Via the E/E Claim MAP dictionary, create a map called LOC or LOCATION,
for example. Then define all the appropriate non-patient LAB specimen
locations on the left side with a digit 4 on the right side.
For example:
Mnemonic LOC
If Data Value In File Is Use This Value On Claim
OBS2 4
Then on page 2 of the Claim Dictionary setup as follows:
Over-
Field Code Type ride Value Map
4 CHECK Y CALC UB92 TOB
TOB D2 CHECK Y LOCATION LOC
Any other accounts that do not have the locations listed in the map
should continue to calculate a TOB based off of the standard CALC UB92
TOB claim value check associated with field 4. If by chance there is
additional criteria, other than location, that determines the
non-patient LAB specimens, the above will not be applicable and
additional evaluation (possibly a custom claim field check) would need
to be created.
------------------------------------------------------------------------
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-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of [EMAIL PROTECTED]
Sent: Friday, March 10, 2006 2:01 PM
To: [email protected]
Subject: RE: [MEDITECH-L] Magic-BAR Medicare Bill Type 141
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We have been addressing this for a while. We have many "Outreach"
locations and don't want
to set up new locations.
Claim Check "CALC UB92 TOB" makes use of a Field "TOB 141" (among
others) and associated Map, to make 141 the Type of Bill. The logic is
along the lines of: If the Account's "Admission Source Code" is one of
these, and the account's Revenue codes are in a Map, make the TOB 141.
Well it seems the definition of Source Code has changed quite a bit over
the years. There
is no more "Other" Admission Source that can be used on a Medicare OP
Claim. They now
seem to want the source code indicating MD Referral whether the patient
is here or their
specimen is brought in.
I have asked Meditech for a custom Claim Field "zTOB 141" that would
work off the
Admission Source MNEMONIC that we build in our Dictionary. Like "NP"
which would indicate
Non-Patient, but still put the Correct Source Code for MD Referral on
the claim
The proposed logic: If the Admission Source MNEMONIC is in list A, and
the Rev Code is in
Map B, Use 141 on the claim.
Is anyone else coming up with alternative solutions?
Thanks,
Rich McNeil
Southcoast Hospitals Group
New Bedford, MA
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Mon Nov 28, 2005 4:12 pm From:
"Marcia S Flessner"
Subject: RE: [MEDITECH-L] Magic-BAR Medicare Bill Type 141
To: "Roger Allen" <[EMAIL PROTECTED]>,
"@Meditech-L" <[email protected]>
From: "Marcia S Flessner" <[EMAIL PROTECTED]>
Date: Mon, 28 Nov 2005 09:37:36 -0600
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======================================
Roger,
We had this clarified when we became a Critical Access Hospital and had
to change to Bill type 851 for our Out Patients. If a patient does not
physic ally enter the building we have made these visits the 141 TOB.
We did this by our location setup in Meditech. If admissions registers
the patient an d the speciman comes from a nursing home patient, we use
a nursing home location. If they register a speciman from a doctor's
office (a path specimen ), then we use a path location. Then in BAR, we
have tied these locations so that they map the TOB to become a 141. It
has been working for us. Hope this helps. Marcia Flessner Mendota
Community Hospital
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-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Behalf Of Roger Allen
Sent: Thursday, November 24, 2005 1:42 PM
To: @Meditech-L
Subject: [MEDITECH-L] Magic-BAR Medicare Bill Type 141
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Has anyone come up with how they are going to handle generating a bill
type 141 for Non-Patient Laboratory Specimens for Medicare patients?
There is a big change as of 4/03/2006 for Medicare type of bill 141. CMS
is now redefining the meaning of the usage of type of bill 141. For our
hospital all outpatient services is now to appear on the 13x type of
bill. TOB 141 is to be only used for when only a lab specimen is sent to
be tested here, i.e. the term"Non-Patient Laboratory Specimen".
---
Roger Allen
HCIS Manager
MRMC - Meadows Regional Medical Center
1703 Meadows Lane
P.O. Box 1048
Vidalia, GA 30475-1048
Phone: 912-538-5860
Fax: 912-538-5351
E-Mail: [EMAIL PROTECTED]
Web: www.meadowsregional.org
---
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