There are two components here. Medical code sets and NonMedical code sets.
For Non-medical code sets, the Data of service is the reference. So we
should use the medical codes that are valid on the date of service.
For Non-medical code sets, the date of Claim generation is the reference.
Please refer to the following regulation:
162.1000
(a) Medical data code sets: Use the applicable medical data code sets
described in section 162.1002 as specified in the implementation
specification adopted under this part that are valid at the time the health
care is furnished.
(b) NonMedical data code sets: Use the non medical data code sets as
described in the implementation specifications adopted under this part that
are valid at the time the transaction is initiated.
Hope this helps.
Thanks
Palani
Cognizant Technology Solutions
201-678-2772
-----Original Message-----
From: Winston, Mike K. [mailto:[EMAIL PROTECTED]]
Sent: Tuesday, May 21, 2002 6:37 AM
To: [EMAIL PROTECTED]; '[EMAIL PROTECTED]'
Subject: Date of service
I know this was discussed, but I want to confirm that opinions have not
changed. When Hipaa is in effect we are planning on using the claims Date of
Service to determine if the claim needs to be fully compliant or not,
example: Claim was submitted prior to Hipaa live date with a "Homegrown
code" the 835 goes out after Hipaa is implemented with the non-compliant
code. or Claims that were not subject to any crossfoot edits prior to hipaa
if adjusted will be sent out on the 835 but will not crossfoot.
We are making the logic based on the claims date of service not the
processed date. Any thoughts?
Mike Winston
Business Systems Analyst
Trigon ISD
Ph (804) 354-4521
Fx (804) 678-0452
[EMAIL PROTECTED]
This message, including files attached to it, may contain confidential
information that is intended only for the use of the ADDRESSEE(S) named
above. If you are not the intended recipient, you are hereby notified that
any dissemination or copying of the information is strictly prohibited. If
you have received this message in error, please notify the sender
immediately and delete the message from your system. Thank you.
This e-mail and any files transmitted with it are for the sole use of the intended
recipient(s) and may contain confidential and privileged information.
If you are not the intended recipient, please contact the sender by reply e-mail and
destroy all copies of the original message.
Any unauthorised review, use, disclosure, dissemination, forwarding, printing or
copying of this email or any action taken in reliance on this e-mail is strictly
prohibited and may be unlawful.
Visit us at http://www.cognizant.com
