The HIPAA Electronic Transaction Final Rule sets forth the requirement for effective dates for codes set thusly:
Subpart J-Code Sets ? 162.1000 General requirements. When conducting a transaction covered by this part, a covered entity must meet the following requirements: (a) Medical data code sets. Use the applicable medical data code sets described in ? 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 nonmedical data code sets as described in the implementation specifications adopted under this part that are valid at the time the transaction is initiated. The other issues you raise re change management and version control will of course have to be addressed at the time new versions of the HIPAA specifications are adopted. Change management and version control are not complicated but must be addressed in rules/requirements, etc. when moving from one version to a newer one. Outside of HIPAA, most industries recognize the business need to support multiple versions of any given EDI transction set. Therefore, good commercial EDI management systems have this capability (handling multiple versions of a transaction set/map by trading partner) designed into them. It's truly not a big technical detail, just something that must be managed. Change management/version control is not unique to EDI and transcends most software systems/tools. Rachel Foerster Principal Rachel Foerster & Associates, Ltd. 39432 North Avenue Beach Park, IL 60099 Voice: 847-872-8070 Fax: 847-872-6860 eMail: [EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]> http://www.rfa-edi.com -----Original Message----- From: Christopher J. Feahr, OD [mailto:[EMAIL PROTECTED]] Sent: Saturday, October 12, 2002 6:24 PM To: Ratayski, Dawn; 'Ossont, Dawn x405'; '[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/. 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/. Posting of advertisements or other commercial use of this listserv is specifically prohibited. ********************************************************************** 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. ====================================================== 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.
