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Back  RFI # 1046: Repriced Approved Revenue Code

Formal vs. Informal Help Informal Formal

Submitter

Donald Graves

Description

Can you please clarify when I would use HCP08, HCP11 and HCP12 in the 2300 Loop? I would think that these elements pertaining to revenue code and service unit count would be germane only at the service level 2400 loop. What is the rationale for allowing these elements at the claim level? When would I need to use them?

Response

This issue is directly addressed in guide 005010X223. The Situational Rules related to the elements in question state that they are only used by repricers and are used "when this information is deemed necessary by the repricer."

Therefore, if you are not a repricer, these are not used. If you are a repricer, these are only used when you determine that their use is necessary, which could apply if you are not providing service specific repricing information.
Submission 5/14/2010
Status Date 6/18/2010
Status F - Final
Primary References
Document 005010X223
Section2
Page316
Set ID837I
Table2
Loop2300
Segment Position2410
Segment IDHCP
Element Position08