Jim You are correct that there is not a good way to do this in the 835. You might try using code '110 - Billing date predates service date' in the claim level CAS but I can see that it would be quite a stretch....
I would suggest that you contact the Codes Maintenance Committee and request a new Adjustment Reason Codes. You might also want to request a new Claim Status Reason Codes if you think you might need this to respond to a claim status inquiry (the same committee handles both code lists). This could be a pre-adjudication rejection. Requests for new codes can be made at http://www.wpc-edi.com/conferences/crc.html. Login and go to the February 2002 Issues and Agenda topic under Issues & Requests (you might have to hit the 'more' button at the bottom of the list). j "J.G." wrote: > Our plan includes both medical as well as limited dental coverage. We do > not do any predetermination of benefits today. If a provider calls in we > tell them we don't predetermine benefits. If they send in a paper form we > respond with a form letter telling them we don't predetermine benefits. If > they ask specific questions on the phone, they may get some additional > information, but nothing that should be close to an actual predetermination. > > The 837 Dental Claim transaction allows for a predetermination request. The > 835 Remittance Advice allows for a response. However, I don't see a way to > indicate that we don't perform predeterminations. Is there a way to do this > in the 835, or is there another way to respond to this? > > Jim Griffin > Business Systems Analyst > CNA > > ********************************************************************** > 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. ********************************************************************** 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.
