Re: Type of Service still needed?

[Doug Webb]

Title: Message

Stacy, Any payer who requires the Type Of Service is not in compliance.  After 16 October, it seems that the only remedy is complaining to CMS.   Since you want to be paid, I would suggest that you populate the field only for those payers who "need" it, document why you are sending a non-complient claim, and send the documentation to CMS (and arrange for any clearinghouses along the way to pass through the TOS without comment).  You could also automatically generate a complaint each time you have to use the TOS, but this might be excessive (if you overwhelm CMS with complaints, they may surrender, and only enforce extreme cases).   The reason the TOS was eliminated is that it is redundant.  If procedure codes are properly used, each procedure code maps to one and only one TOS.  If  Surgical codes have been mis-used as Anasthesia codes, then the TOS could come into play to separate the Surgery from the Anasthesia.  In that case, you have 2 issues -- use of the TOS and mis-use of the Procedure Code.  Illinois Medicaid throws another curve -- they want each TOS on a separate claim (this is not usually a problem for me, since most of the procedures we bill for have the same TOS).   The opinions expressed here are my own and not necessarily the opinion of LCMH.   Douglas M. Webb Computer System Engineer Little Company of Mary Hospital & Health Care Centers [EMAIL PROTECTED]   "This electronic message may contain information that is confidential and/or legally privileged. It is intended only for the use of the individual(s) and entity(s)  named as recipients in the message. If you are not an intended recipient of the message, please notify the sender immediately,  delete the material from any computer, do not deliver, distribute, or copy this message, and do not disclose its contents or take action in reliance on the information it contains. Thank you."     ----- Original Message ----- From: Stacy Trease To: WEDI SNIP Transactions Workgroup List Sent: Wednesday, March 19, 2003 02:41 PM Subject: Type of Service still needed? Many of the payers we have been testing with are informing us that they will still need to receive the type of service code for claims after 10/16/2003.  In the implementation guide, SV106 is marked as not used.   Is anyone else running into this, and if so, how have you been handling it?    Thanks for your input! Stacy M. Trease EDI Programmer/Analyst, Gateway EDI Inc. Co-Chair, MO SNIP TCS Subcommittee (800) 969-3666  Ext 224 [EMAIL PROTECTED]   ------------ Gateway EDI, Inc. --------------------------------------------------------------------------------------------------- This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended addressee, or the person responsible for delivering it to them, you may not copy, forward, disclose or otherwise use it or any part of it in any way. To do so may be unlawful. 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