Kepa and Deepan,

Since all of level 6  Rules are present in the Implemetaion Guide,
it is difficult to distinguish a Level 4 Rule from a Level 6 rule.

For example :
Standard : 837 Proffesional
loop : 2300

DTP : Data last seen is
Required when claims involve services from an independent physical
therapist, occupational therapist, or physician services involving
routine foot care
is level 6 rule. It involves Medical Speciality testing.

CR2 : SPINAL MANIPULATION SERVICE INFORMATION
Required on all claims involving spinal manipulation. Such claims
could originate with chiropractors, physical therapists, DOs, and
many other types of health care providers.
Now this appears to be a level 6 rule as it too has Speciality testing.

But actually is a ***level 4*** rule because it has a ***inter segment***
dependency on
the following segment.

DTP : DATE INITIAL TREATMENT which states that it is
Required on all claims involving spinal manipulation.

Hence a formal definition of level 4 and Level 6 rule is essential,
to remove such conflicting issues in level checking.

When does a inter segment Sitiuational dependency (Level 4) Rule
become a Speciality (level 6) Rule.

Manohar.

----- Original Message -----
From: Kepa Zubeldia <[EMAIL PROTECTED]>
To: Deepan Vashi <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]>;
<[EMAIL PROTECTED]>
Cc: Deepan Vashi <[EMAIL PROTECTED]>
Sent: Wednesday, June 12, 2002 9:38 PM
Subject: Re: Business requirements for 6th level of testing for T&CS as per
WEDI WhitePaper


> Deepan,
>
> All of these requirements are in the HIPAA implementation guides.
>
> Kepa
>
>
>
> On Wednesday 12 June 2002 04:58 am, Deepan Vashi wrote:
> > Dear Friends,
> > WEDI has published a WhitePaper for 6 Levels of Testing of HIPAA
Transaction
> Sets.
> >
> > Can any one suggest from where can I gather business requirments of
> following specialities
> > as mentioned in Testing Whitepaper for level 6 compliance?
> >
> > Product Types / Types of Service testing.
> >
> >   a.. ambulance
> >   b.. chiropractic
> >   c.. podiatry
> >   d.. home health
> >   e.. parenteral and enteral nutrition
> >   f.. durable medical equipment
> >   g.. psychiatry
> >   h.. and other specialties
> > Suggestions for Web resources if any will be highly appreciated.
> >
> > Thanks and best regards
> >
> > Deepan
> >
>
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