I agree, the version of non medical code sets editing within your transactions needs to be based on the tranamission date of the transaction. You basically need to replace the older version of code sets with the newer version. This becomes a bit more work if you have crosswalked HIPAA values to propritery codes.
The Medical codes need to be edited based on the Date of service for which they were submitted. Becareful with the modifiers because they are also part of the medical code sets and can have effective and termination dates separate from the procedure codes they modify. -----Original Message----- From: Dhandapani, Palani (Cognizant) [mailto:[EMAIL PROTECTED]] Sent: Tuesday, May 21, 2002 10:15 AM To: Winston, Mike K.; [EMAIL PROTECTED]; '[EMAIL PROTECTED]' Subject: RE: Date of service There are two components here. Medical code sets and NonMedical code sets. For Non-medical code sets, the Data of service is the reference. So we should use the medical codes that are valid on the date of service. For Non-medical code sets, the date of Claim generation is the reference. Please refer to the following regulation: 162.1000 (a) Medical data code sets: Use the applicable medical data code sets described in section 162.1002 as specified in the implementation specification adopted under this part that are valid at the time the health care is furnished. (b) NonMedical data code sets: Use the non medical data code sets as described in the implementation specifications adopted under this part that are valid at the time the transaction is initiated. Hope this helps. Thanks Palani Cognizant Technology Solutions 201-678-2772 -----Original Message----- From: Winston, Mike K. [mailto:[EMAIL PROTECTED]] Sent: Tuesday, May 21, 2002 6:37 AM To: [EMAIL PROTECTED]; '[EMAIL PROTECTED]' Subject: Date of service I know this was discussed, but I want to confirm that opinions have not changed. When Hipaa is in effect we are planning on using the claims Date of Service to determine if the claim needs to be fully compliant or not, example: Claim was submitted prior to Hipaa live date with a "Homegrown code" the 835 goes out after Hipaa is implemented with the non-compliant code. or Claims that were not subject to any crossfoot edits prior to hipaa if adjusted will be sent out on the 835 but will not crossfoot. We are making the logic based on the claims date of service not the processed date. Any thoughts? Mike Winston Business Systems Analyst Trigon ISD Ph (804) 354-4521 Fx (804) 678-0452 [EMAIL PROTECTED] This message, including files attached to it, may contain confidential information that is intended only for the use of the ADDRESSEE(S) named above. If you are not the intended recipient, you are hereby notified that any dissemination or copying of the information is strictly prohibited. If you have received this message in error, please notify the sender immediately and delete the message from your system. Thank you. To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=business and enter your email address. 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. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.
