I'm sure this issue has been encountered, discussed and resolved many times
over by this time, so I'm anticipating that someone will be able to just
point me in the right direction.

There are several code sets commonly used for payment purposes and used by
CMS as well to determine payment such as ASC, CMG, IRF, RUG, etc..  Many
providers are instructed to bill using these "Payment" or "Procedure
Grouping" codes.  Are these code sets considered to be medical or
non-medical code sets and how are other organizations handling these type of
codes in an 837 and/or an 835 if they cannot be sent as a procedure code?

Thank you in advance for any information you can provide on this issue.

Sandra L. Weiler
Mercy Health Plans
(314) 214-8056

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