How should local codes be managed given
the HIPAA standards and guidelines?
Kaye Laymance
Business Integrator - Product Management
Availity, L.L.C.
904-470-4928
-----Original Message-----
From: Brandi Wyatt
[mailto:[EMAIL PROTECTED]
Sent: Monday, June 02, 2003 2:02
PM
To: WEDI SNIP Transactions
Workgroup List
Subject: RE: Cut off dates for TCS
The first part of Doug's statement
for both medical and non-medical code set use by "date" is correct.
I'd like to take it one step further for clarification:
1. Medical code sets are validated
by a) date of service, and b) each code is valid by the dates specified by the
organization responsible for maintaining that code list (per the FR � 162.1011)
2. Non-medical code sets are
validated by a) date of transaction and b) each code is valid by the dates
specified by the organization responsible for maintaining that code list (per
the FR � 162.1011)
Supporting documentation can be
found via the FR, Subpart J - Code Sets, section � 162.1000 General
Requirements - also found in the Preamble on Page 50323 under "Proposed
Code Sets Response"
-----Original
Message-----
From: Doug Webb
[mailto:[EMAIL PROTECTED]
Sent: Monday, June 02, 2003 10:06
AM
To: WEDI SNIP Transactions
Workgroup List
Subject: Re: Cut off dates for TCS
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
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----- Original Message -----
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
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