Chris,
Transactions like the 270 and 278 allow the requester to indicate a future date of service or admission date, so these are available for validating the code set. While it is possible the submitted code will no longer be valid for dates of service in the future, unless the new codes have been release there is no way to tell. (Unless you have an Oracle database -- I hear they can see into the future...). We are expecting to maintain codes for a few years after they are no longer effective, so we can correctly validate claims whose submission is delayed. As far as what X12 version needs to be submitted, I cannot imagine how, in the real world, you can avoid having to support multiple versions for at least some period of time. Logistics of roll-out to trading partners would make it unlikely that larger entities could switch everyone to the same version on the same day. So resubmitted claims would be expected in whatever format the two entities currently agree to exchange (and indicated in GS08). Michael Lachenmayer Lead Systems Analyst Independence Blue Cross Ph: 215.241.9453 Fx: 215.241.4239 -----Original Message----- From: Christopher J. Feahr, OD [mailto:[EMAIL PROTECTED]] Sent: Saturday, October 12, 2002 7:24 PM To: [EMAIL PROTECTED] Cc: [EMAIL PROTECTED] Subject: RE: Code set effective dates Dawn, Please pardon the cross-post to "transactions", but this reminds me of a couple other version-date issues that I'd like to bounce off the transaction gurus. If the code-set version is determined by "date of service", what will drive the choice of code-set for transactions sent in advance of the actual service... like the 270? In any case, it appears that senders will have to maintain current and [possibly several] previous code-sets so that claims submitted [up to a year, possibly] after a code-set update can be created with the codes that were in effect on the date of service... right? My other question is regarding the correct transaction version to use, which (if I understand correctly) is driven by the date of the transaction, as opposed to the service-date. So, does this mean that a claim REsubmitted after the required implementation date of new transaction version, would have to be reformatted for the new transaction version? Would there ever be a scenario in which a sending system's translator or a receiving system's validator would have to be able to support BOTH old and new transaction versions? If so, which date-field in the interchange determines the choice of transaction version? Thanks, -Chris Christopher J. Feahr, OD Optiserv Consulting [For the vision care industry] Santa Rosa, CA 707-579-4984 707-529-2268 (cell/pager) http://VisionDataStandard.org http://Optiserv.com At 03:09 PM 10/11/2002 -0400, Ratayski, Dawn wrote: >Hi Dawn, > >I had the same concern and have brought it to the BCBSA association along >with many other Blues plans nationwide to address with CMS. CMS is choosing >not to change their practices at this time. > >HIPAA does not address this. CMS is a covered entity under HIPAA and the >regs state the codes must be valid for the date of service for which they >are billed. This means NO grace period. CMS is sending and inconsistent >message to the provider community by continuing to allow a grace period. > >[EMAIL PROTECTED] >TCI Project Developer >Blue Cross of Northeastern Pennsylvania > > > >-----Original Message----- >From: Ossont, Dawn x405 [mailto:[EMAIL PROTECTED]] >Sent: Friday, October 11, 2002 1:12 PM >To: '[EMAIL PROTECTED]' >Subject: Code set effective dates > > >Hello, > >I'm looking for any information regarding the effective dates of ICD-9-CM >and HCPCS code sets. CMS currently allows providers to utilize a grace >period. For example, providers are not required to use HCPCS codes until >4/1 (and they can start submitting 1/1). How does HIPAA address this? > >Thanks! > >Dawn Ossont >Reimbursement Team Leader >Preferred Care > >phone: 716.327.2405 >fax: 716.327.2289 >e-mail: [EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]> > > > >To be removed from this list, go to: >http://snip.wedi.org/unsubscribe.cfm?list=codeset and enter your email >address. > >The WEDI SNIP listserv to which you are subscribed is not moderated. The >discussions on this listserv therefore represent the views of the individual >participants, and do not necessarily represent the views of the WEDI Board >of Directors nor WEDI SNIP. If you wish to receive an official opinion, >post your question to the WEDI SNIP Issues Database at >http://snip.wedi.org/tracking/. Posting of advertisements or other >commercial use of this listserv is specifically prohibited. > > > >To be removed from this list, go to: >http://snip.wedi.org/unsubscribe.cfm?list=codeset and enter your email address. > >The WEDI SNIP listserv to which you are subscribed is not moderated. The >discussions on this listserv therefore represent the views of the >individual participants, and do not necessarily represent the views of the >WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official >opinion, post your question to the WEDI SNIP Issues Database at >http://snip.wedi.org/tracking/. 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