Part of the answer lies in where this information is reported in the 837.
For instance, at the line level (2400 loop, SV202segment, pg.446 in the IG)
where the HCPCS can be reported, the note specifies "required for all
Outpatient claims". This is not something out corp. currently requires of
facilities, but I suppose it will be sent.
-M.J.L.
"Jim Moores"
<Jim.Moores@AntaresSolu To: [EMAIL PROTECTED],
[EMAIL PROTECTED], [EMAIL PROTECTED]
tions.com> cc: "George Kaye"
<[EMAIL PROTECTED]>
Subject: ICD9 Procedure Codes
vs HCPCS Procedure Codes
08/28/2001 04:29 PM
Please respond to
transactions
Hi All,
I think that this is an easy question (I hope). When we price Outpatient
Surgeries we use the APG system that uses both the ICD9 Procedure Codes and
the HCPCS Procedure Codes (so I've been told). Both data elements are in
the 837 I transaction.
The question: The 837I IG is unclear if we can require BOTH procedure
codes for outpatient claims... The HCPCS seems to be situational, but
without comment. I've read that no comments means "send it if you've got
it". The difference is, we need to price accurately.
Bottom line: Can we require Institutional Providers of Care to send us
both for Outpatient Claims in some sort of contractual arrangement (network
contract).
Any comments and observations gratefully accepted.
Thanks all,
**********************************************************************
To be removed from this list, send a message to:
[EMAIL PROTECTED]
Please note that it may take up to 72 hours to process your request.
------------------------------------------------------------------------------
CONFIDENTIALITY NOTICE: This message is intended only for the
use of the individual or entity to which it is addressed and may contain
information that is privileged, confidential or exempt from disclosure
under applicable law. If the reader of this message is not the intended
recipient or the employee or agent responsible for delivering the message
to the intended recipient, you are hereby notified that you are strictly
prohibited from printing, storing, disseminating, distributing or copying
this communication. If you have received this communication in error,
please notify us immediately by replying to the message and deleting it
from your computer. Thank You, Antares Management Solutions.
==============================================================================
**********************************************************************
To be removed from this list, send a message to: [EMAIL PROTECTED]
Please note that it may take up to 72 hours to process your request.
