Claim that spans two code set effective periods....

[Jim Moores]

Hi All,     I've been asked to see what other payers and providers are doing about the following situation:  If an ICD-9 procedure code that resides at the header level on an inpatient claim, and the inpatient claim has dates of service that span two effective periods for that code set, where the code is valid in one period and invalid in the other, should the payer accept the claim and process it as HIPAA compliant?  The example is for an ICD-9 procedure code at the header, but I really think that the question can be generalized to apply to any code set at the header or bill line.     My recommendation is that whatever is effective on the admit date should rule for the entire claim.  Does anyone have any other thoughts or would like to confirm my recommendation?   Thanks all,   Jim   Jim Moores - HIPAA Team Leader - Privacy Antares Management Solutions 23700 Commerce Park Road Beachwood, Ohio   44122-5832   [EMAIL PROTECTED] Phone: (216)292-1605 Fax:      (216)292-1619   ------------------------------------------------------------------------------ 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. ==============================================================================