Response:
The ADA will change the leading ‘‘0’’ to a ‘‘D’’ as proposed. Many organizations are already using the ‘‘D’’ Codes, which contains the leading ‘‘D,’’ without difficulty, and we expect others to make this transition without difficulty. Although we did not receive comments that specifically addressed the removal of the dental codes from the HCPCS, general comments about the desirability of more consolidated access to all HIPAA code sets have led us to revise our position on the inclusion of ‘‘The Code’’ in the HCPCS. Thus, the dental codes will be available from two sources: the ADA, and through a licensing agreement between HCFA and the ADA.<< End quote >>
Tom Drinkard
EDIT,
Inc.
[EMAIL PROTECTED]
(678) 795-1251 (voice)
(775)
458-6117 (fax)
-----Original Message-----
From: Fleming, Cindy R
[mailto:[EMAIL PROTECTED]]
Sent:
Tuesday, March 18, 2003 10:46 AM
To: WEDI SNIP Transactions Workgroup
List
Subject: RE: 835D or P for Medicare dental
claims?
Tom,
Below you state that the ADA codes are included in
HCPCS. Where is that documented? I have checked the HCPCS 2003 manual and
did not find that reference?
Thank you,
Cindy Fleming
Private
Programs HIPAA Project Office Coordinator
Arkansas BlueCross
BlueShield
[EMAIL PROTECTED]
501-399-3833
> NOTICE:
This e-mail and any files transmitted with it are confidential
>
and
are intended solely for the use of the individual or entity to whom they
are addressed. If you have received this e-mail in error, please notify
the Arkansas Blue Cross and Blue Shield Micro Services Help Desk at (501) 378
-2317, option 2.
-----Original Message-----
From: Tom Drinkard [mailto:[EMAIL PROTECTED]]
Sent:
Thursday, March 13, 2003 2:49 PM
To: WEDI SNIP Transactions Workgroup
List
Cc: 'Stanley Nachimson (E-mail)'
Subject: RE: 835D or P for Medicare
dental claims?
With respect, I disagree.
While it would be simpler
for many if all "Dental" claims used the 837-D, that is not the case. As I
understand it, HHS has licensed the Code on Dental Procedures and Nomenclature
from the ADA and includes the entire code set in HCPCS. Consequently, the 837-P
(and the 837-I, for that matter) fully supports all of the "ADA" procedure
codes.
Here are some of the scenarios where an 837-D is more appropriate:
. For predeterminations (aka pre-treatment estimates) . If missing
teeth information must be reported. . If tooth codes, tooth surfaces or
oral cavity areas must be reported. . If certain dates must be reported
(Initial placement date, Appliance Placement Date, etc.)
Here are some of
the scenarios where an 837-P is more appropriate: . To report diagnosis
codes
. To report procedure code modifiers
The above lists are
certainly not exhaustive, but are intended to highlight some of the differences
between the 837-D and the 837-P. Lack of support for the "ADA" codes is not one
of the differences.
Hope this helps.
Tom Drinkard
EDIT,
Inc.
[EMAIL PROTECTED]
(678) 795-1251 (voice)
(775)
458-6117 (fax)
-----Original Message-----
From: Fulton, Rick [mailto:[EMAIL PROTECTED]]
Sent:
Thursday, March 13, 2003 1:14 PM
To: WEDI SNIP Transactions Workgroup
List
Cc: Stanley Nachimson (E-mail)
Subject: RE: 835D or P for Medicare
dental claims?
They need to use the 837 D (Dental)
transaction
-----Original Message-----
From: Tucci-Kaufhold, Ruth A.
[mailto:[EMAIL PROTECTED]]
Sent:
Thursday, March 13, 2003 12:32 PM
To: WEDI SNIP Transactions Workgroup
List
Cc: Stanley Nachimson (E-mail)
Subject: RE: 835D or P for Medicare
dental claims?
I am concerned Medicare would not be
compliant.
How can Medicare state that they won't accept a HIPAA
mandated transaction? Isn't Medicare a payer too?
The ADA codes are
not included in the 837-P(at least not in the Appendix C for the v4010 Imp
Guide) ... so only those dental codes that are in HCPCS would be available for
payment by Medicare? Could more detail be given on this
subject?
Ruth Tucci-Kaufhold
HIPAA Systems Analyst
Co-Founder
MAHI
UNISYS Corporation
4050 Innslake Drive
Suite 202
Glen Allen,
VA 23060
(804) 346-1138
(804) 935-1647
(fax)
N246-1138
[EMAIL PROTECTED]
-----Original
Message-----
From: Kathleen Simmons [mailto:[EMAIL PROTECTED]]
Sent:
Thursday, March 13, 2003 6:27 AM
To: WEDI SNIP Transactions Workgroup
List
Subject: RE: 835D or P for Medicare dental claims?
That's
correct. Medicare does not cover general dental care, but under our
medical benefits, we do pay for treatment of injuries to the mouth area, some of
which may be performed by a dentist. We will not accept the 837-D, only
the 837-P.
>>> "Tom Drinkard"
<[EMAIL PROTECTED]> 03/12/03 06:11PM
>>>
>>>
Diana,
As I understand it, Medicare will not accept the 837D,
since Medicare requires the diagnosis code. So, all Dental claims must be
submitted on the 837P.
Keep in mind that Medicare processes only 0.25
million Dental claims per year. That really isn't very many claims by Medicare
standards. Since Medicare doesn't really cover Dental procedures, I
suspect that the majority of the claims are those things that cross over between
Dental and Medical such as high-end Oral Surgery procedures.
Hopefully
someone from CMS will chip in and confirm the above.
Tom
Drinkard
EDIT, Inc.
[EMAIL PROTECTED]
(678) 795-1251
(voice)
(775) 458-6117 (fax)
-----Original Message-----
From: Diana
Lindsley [mailto:[EMAIL PROTECTED]]
Sent:
Wednesday, March 12, 2003 5:04 PM
To: WEDI SNIP Transactions Workgroup
List
Subject: 835D or P for Medicare dental claims?
We have
heard several different requirements, but have not gotten a definitive
response. Hopefully, someone on this list will know. We have heard
that Medicare will require the 837P transaction for dental claims, which doesn't
make much sense to us. We have also heard that the 837D can be used.
Does anyone know which will be required?
Diana Lindsley
Project
Manager
First Pacific Corp.
---
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/.
These listservs should not be used for commercial marketing purposes or
discussion of specific vendor products and services. They also are not intended
to be used as a forum for personal disagreements or unprofessional communication
at any time.
You are currently subscribed to wedi-transactions as:
[EMAIL PROTECTED]
To unsubscribe from this list, go to the
Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank
email to [EMAIL PROTECTED]
If you need to
unsubscribe but your current email address is not the same as the address
subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
---
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/.
These
listservs should not be used for commercial marketing purposes or discussion of
specific vendor products and services. They also are not intended to be
used as a forum for personal disagreements or unprofessional communication at
any time.
You are currently subscribed to wedi-transactions as:
[EMAIL PROTECTED]
To unsubscribe from this list, go to the
Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank
email to [EMAIL PROTECTED]
If you need to
unsubscribe but your current email address is not the same as the address
subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
---
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/.
These listservs should not be used for
commercial marketing purposes or
discussion of specific vendor products and services. They also are not
intended to be used as a forum for personal disagreements or unprofessional
communication at any time.
You are currently subscribed to
wedi-transactions as: [EMAIL PROTECTED] To unsubscribe from this
list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank
email to [EMAIL PROTECTED]
If you need to
unsubscribe but your current email address is not the same as the address
subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
---
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/.
These listservs should not be used for
commercial marketing purposes or
discussion of specific vendor products and services. They also are not
intended to be used as a forum for personal disagreements or unprofessional
communication at any time.
You are currently subscribed to
wedi-transactions as: [EMAIL PROTECTED] To unsubscribe from this list, go to
the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank
email to [EMAIL PROTECTED]
If you need to
unsubscribe but your current email address is not the same as the address
subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
---
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/.
These listservs should not be used for
commercial marketing purposes or
discussion of specific vendor products and services. They also are not
intended to be used as a forum for personal disagreements or unprofessional
communication at any time.
You are currently subscribed to
wedi-transactions as: [EMAIL PROTECTED] To unsubscribe from this
list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank
email to [EMAIL PROTECTED]
If you need to
unsubscribe but your current email address is not the same as the address
subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
---
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/.
These listservs should not be used for
commercial marketing purposes or
discussion of specific vendor products and services. They also are not
intended to be used as a forum for personal disagreements or unprofessional
communication at any time.
You are currently subscribed to
wedi-transactions as: [EMAIL PROTECTED] To unsubscribe from this list,
go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank
email to [EMAIL PROTECTED]
If you need to
unsubscribe but your current email address is not the same as the address
subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
---
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/.
These listservs should not be used for commercial marketing purposes or
discussion of specific vendor products and services. They also are not
intended to be used as a forum for personal disagreements or unprofessional
communication at any time.
You are currently subscribed to
wedi-transactions as: [EMAIL PROTECTED] To unsubscribe from this
list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank
email to [EMAIL PROTECTED]
If you need to
unsubscribe but your current email address is not the same as the address
subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
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/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time.
You are currently subscribed to wedi-transactions as: [EMAIL PROTECTED]
To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED]
If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
