I would think the explanation of bundling and unbundling on pg 25 - 27 of the 835 
Implementation Guide should help, regardless of whether or not the claim was 
institutional or professional or dental.

Jon Fox
eCommerce Analyst
Independent Health

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>>> "Tucci-Kaufhold, Ruth A." <[EMAIL PROTECTED]> 01/14/02 04:47PM >>>
To the group ...
 
Does anyone have an answer for this question?
 

Ruth Tucci-Kaufhold 
UNISYS Corporation 
4050 Innslake Drive 
Suite 202 
Glen Allen, VA  23060 
(804) 346-1138 
(804) 935-1647 (fax) 
N246-1138 
[EMAIL PROTECTED] 

-----Original Message-----
From: McLaughlin, Mark [mailto:[EMAIL PROTECTED]] 
Sent: Thursday, January 10, 2002 3:00 PM
To: Tucci-Kaufhold, Ruth A.
Subject: FW: Question about returning the DRG in the 835



Another one. 

> Mark 
> 
> Mark McLaughlin 
> Regulatory Policy Analyst 
> McKesson 
> 700 Locust St. Suite 500 
> Mail stop IADU-7 
> Dubuque, IA  52001 
> (563) 557-3654 phone 
> (563) 557-3334 fax 
> [EMAIL PROTECTED] 
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> 


-----Original Message----- 
From: Falbowski, Ellen [ mailto:[EMAIL PROTECTED] 
<mailto:[EMAIL PROTECTED]> ] 
Sent: Wednesday, January 09, 2002 9:47 AM 
To: [EMAIL PROTECTED] 
Subject: Question about returning the DRG in the 835 


The note on the CLP11 says, "This data element is specific to institutional 
claims and adjudication considers the DRG." 
  
My question is, if a payer changes the DRG during the course of adjudicating

the claim, which DRG should be returned in the 835:  the one submitted in 
the 837I (in the 2300: HI*DR), or the one that was derived by the payer? 
  
The IG does not seem to specify.  Is there a common practice? 
  
Thanks. 


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