RE: Cut off dates for TCS

[Linda McCardel]

The final rule for Transactions and Code Sets states in 45 CFR Part 162, Subpart J: �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 service 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. �162.1002 Medical Data Code Sets (This section names ICD-9-CM Volumes 1, 2 &3 as maintained by HHS, NDC as maintained by HHS, CDT as maintained by the American Dental Association, and the combination of HCPCS maintained by HHS and CPT as maintained by the American Medical Association.) � 162.1011 Valid Code Sets Each code set is valid within the dates specified by the organization responsible for maintaining that code set. -----Original Message----- From: Barry Dupree [mailto:[EMAIL PROTECTED] Sent: Monday, June 02, 2003 1:46 PM To: WEDI SNIP Transactions Workgroup List Subject: RE: Cut off dates for TCS Hi Doug, I agree with your assessment, but was wondering if you could please site your source of your information?  I ask ONLY because, as Miriam points out, there are many conflicting opinions on this issue.  No offense intended, just looking for more information to bolster our position. Thank you Barry DuPree Installation Manager AXIOM Systems, Inc. 20300 Century Blvd. Suite 120 Germantown, MD 20874-1110 Direct: 301-840-9165 x206 Main: 301-840-3861 Fax: 301-840-3873 [EMAIL PROTECTED] -----Original Message----- From: Doug Webb [mailto:[EMAIL PROTECTED] Sent: Monday, June 02, 2003 1:06 PM To: WEDI SNIP Transactions Workgroup List Subject: Re: Cut off dates for TCS Miriam, It depends.  If the code set is "Medical" (such as CPT codes) , the cut-off is based on the Date of Service; for "Non-medical" codes (such as ZIP codes and Provider Taxonomy), the cut-off is based on the Date of Transaction. For claims crossing a transition date, confusion reigns.  I would ensure that the two different code sets were in different claims (codes that appear in Subscriber level segments or below), or Transactions (codes that appear in higher-level segments).   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: Miriam Paramore To: WEDI SNIP Transactions Workgroup List Sent: Monday, June 02, 2003 11:44 AM Subject: Cut off dates for TCS Have heard conflicting reports from lots of experts that I respect... So...   Is use of the HIPAA code sets dependent on the date of service of the claim, or the transmission date of the file?  What happens when the file contains a mix of dates of service and some of those claims use the HIPAA codes and some do not?     Best Regards, Miriam J. Paramore (Co-Founder and President of HAWK) President & CEO PCI: e-commerce for healthcare 9001 Shelbyville Road iTRC Building Louisville, KY 40222 502-429-8555 www.hipaasurvival.com =========================================== This email contains confidential information intended only for the named addressee(s). Any use, distribution, copying or disclosure by any other person is strictly prohibited.   --- 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. 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