Workers compensation claims need not meet any of the transaction standards.  There is 
nothing "non-compliant" in this scenario.

Stanley Nachimson
Office of Information Services, CMS
410-786-6153

>>> [EMAIL PROTECTED] 01/24/02 10:37AM >>>
I would like to hear the opinion of either CMS or OCR on this issue.


----- Original Message -----
Sent: Tuesday, January 15, 2002 3:15 AM
Subject: Covered Transactions


> A covered entity (such as a provider) sends a non-covered transaction
(such
> as a Workers' Comp claim) to a covered entity (such as a payer who
services
> both Workers' Comp and other covered services) using a named transaction
> (such as the 837 professional version 4010) and uses code values that do
not
> violate the 837 version 4010 standard, but are not covered in the HIPAA
> implementation guide.  The payer then sends an 835 version 4010 payment /
> remittance advice for the same transaction back to the provider, using
code
> values that do not violate the 835 version 4010 standard, but are not
> covered in the HIPAA implementation guide for the 835 version 4010.
>
> Are either of the transactions or entities non-compliant anywhere in this
> process?
>
> Ken Steen
> VP, Information Systems
> Apollo Enterprises
>




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