I would like to participate in the sub-subworkgroup addressing ambiguities
in the IG's.  I attended today's Testing Subworkgroup meeting, and here is
the gist of what I heard on this topic, plus some of my further thoughts:

We discussed two approaches, one short-term and one long-term.  For the
short term, Kepa Zubeldia mentioned "sticky notes" that could be attached to
the IG's that would remove the ambiguity regarding when to use a
situationally defined item.  For example, the 837P guide says on the 2000B:
PAT08 (Patient Weight), "Required on claims / encounters for delivery
services to report newborn's birthweight" -- but how does the receiver of a
claim know when this condition has been satisfied, i.e., when the patient is
a newborn?  The "sticky note" could define the situation:  for example, a
newborn is a patient whose date of birth is within 30 days (or 60, or
whatever) of the claim service date.  A claim receiver could then compare
the date of birth and the claim service date to determine whether or not the
condition applies, and thus whether the situational edit applies.  Best of
all, with this unambiguous definition of the situation, every claim receiver
who chooses to use this "sticky note" would arrive at the same conclusion
regarding whether the claim is or is not compliant.

So the short-term work for this work group could be to go through each of
the situational edits in each of the guides, and develop a "sticky note" for
each one that will enable every user (sender and receiver) to determine,
unambiguously, when a situational condition has been satisfied.  It would
still be up to the user to read and apply these sticky notes in his or her
edits, but at least (to the extent that the industry agrees to use these
"sticky notes") it is possible to stamp out the ambiguity in the situational
edits.  (Does this work really belong in the WEDI SNIP Testing Subworkgroup,
or are we possibly stepping on the toes of the IG developers?)

For the long term, we could develop a method of codifying the "sticky notes"
into the X12 implementation guides.  This would enable the situational edits
to be represented in the Washington Publishing tables in such a way that
software developers could upload the situational edits / business rules (in
the future) along with the syntax rules (available currently).  Once these
business rules are represented in code (rather than only in text, as they
are today), they would be as standard and as unambiguous as the syntax rules
are today.  The implication of this is that X12 IG developers would need to
bring a more rigorous approach to the development of business rules --
possibly more upfront work but a much happier outcome.  Rachel Foerster and
Kepa both mentioned IMPDEF as a possible method of codifying the business
rules, and Rachel is willing to provide some level-setting on IMPDEF.  (Even
more than the short-term work above, I'm not sure whether this long-term
work really belongs in the WEDI SNIP Testing Subworkgroup -- or perhaps
elsewhere in WEDI SNIP -- or perhaps in the X12 committee.  In any case, I
think it is important work that has the potential of providing a quantum
leap in IG usability.)

Did other attendees, especially Kerry and Marcallee, come away from today's
meeting with the same understandings as I did about stamping out ambiguities
in the IGs?

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] 
Sent: Thursday, December 19, 2002 1:49 PM
To: WEDI SNIP Testing Subworkgroup List
Subject: Meeting Minutes - 12/19/2002


Hello all,

Below are the minutes from our meeting earlier today.

1)  After our last meeting, John sent out an email message to the listserve
asking for ways we could be more flexible.  He got some responses from
people on the West Coast asking if we could move our meeting time to later
in the day.  Our meetings currently start at 8:00 a.m. on the west coast.
The group agreed to move the meeting to 11:30 eastern time (8:30 on the west
coast) and see if we would get more participation.

2)  The majority of the meeting centered around discussion of the projects
that the group has in front of us.  The group decided that we would
concentrate on two of the seven items.  Ed Hafner and John Huff will
co-chair a workgroup that will address a survey to the industry for common
testing issues in implementing the HIPAA transactions and code sets. Rachel
Forester and Kepa Zubeldia offered to assist with the group.  John also has
some email responses from people that offered to help with this effort.
John will forward those email addresses to Ed Hafner. This group will have
their first conference call on 12/26 at 11 a.m. eastern time. Please contact
Ed Hafner if you would like to participate.

 The second workgroup will tackle the ambiguities in the implementation
guides.  This effort will center around clarifying the existing ambiguities
and offering assistance on how these ambiguities should be handled in this
initial HIPAA implementation.  Ellen S (sorry, I didn't get your last name),
Kerry Zajicek, and Marcelee Jackson volunteered to work in this group.
However, there were no immediate volunteers to lead the group.

The remaining projects will be tackled as time and resources allow.

3)  Brandi Wyatt could not attend the call but she let John know that she
was almost finished with the clean up effort of the dental technical
scenario spreadsheet.  John Lilleston is about 50% finished with the
institutional technical scenarios.  These should be delivered to Claredi
again by sometime in early January.

Our next call will be January 2, 2003 at 11:30 a.m. eastern time.  The call
in numbers are 703-736-7290 passcode 1315339.  You may also use
1-800-495-0245 with the same passcode.  Thanks!!!
_______________________________________________

John Lilleston
Technical Supervisor - Healthcare EDI
Verizon Information Technologies, Inc.
Healthcare Solutions
Phone: 813-979-3225
Fax:  813-978-5570
[EMAIL PROTECTED]
http://www.VerizonIT.com/ _______________________________________________




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you wish to receive an official opinion, post your question to the WEDI SNIP Issues 
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