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Marsha,
No. CMS has "blessed" use of non-complient codes for
dates of service before 16 Oct 2003.
The 385 is complient if it uses the code set that was valid at
the date of service. Local codes are included in this up till the
deadline.
My main reason for avoiding more than one code set in a claim
ia to avoid confusing myself (and, if I am confused, how about the
payer?).
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]
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----- Original Message -----
Sent: Monday, June 02, 2003 12:35
PM
Subject: Re: Cut off dates for TCS
Doug,
What do you do with non-Claims non-Enrollment
transactions like the 835s in
your scenario?
The 835 Remittance will
be produced from a - let's say weekly - Claims Financial process.
It will
contain all the claims paid, denied, adjusted or voided during the previous
work week.
The dates of service will vary widely!
So if the extract
has a mix of claims ... and therefore a mix of HIPAA compliant
and
non-compliant Medical Codes Set values ... won't this produce a
non-compliant 835 ?
Marsha
Verizon Information
Technologies
Managed Care Division
Phoenix, AZ
Home of the Back To
Back NL West Champion ARIZONA DIAMONDBACKS
Phone -
602.678.6042
Fax - 602.678.6331
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"Doug
Webb"
<[EMAIL PROTECTED]>
To: "WEDI SNIP Transactions Workgroup
List"
<[EMAIL PROTECTED]>
06/02/2003 10:06
cc:
AM
Subject: Re: Cut off dates for
TCS
Please respond
to
"Doug
Webb"
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
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----- 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
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