RFI Browser

Back  RFI # 1169: Service ID Qualifier

Formal vs. Informal Help Informal Formal

Submitter

ben bartek

Description

TR3 - pg 187 REQUIRED SVC01 - 1 235 Product/Service ID Qualifier M ID 2/2

The code "ZZ" has been deleted from SVC01-1.

How does a Payer handle former mutually defined codes? They used 'ZZ' to report their local procedure codes. Please indicate which code will be used when reporting local procedure codes back to the provider.

Submitter Assigned Keywords

SVC01 - 1 235 Product/Service ID Qualifier M ID 2/2

Response

This issue is explicitly addressed in guides 004010X091 and 005010X221. The code ZZ in SVC01 was NOT useable for health plan proprietary codes. The note on that code read "This is used to convey the Health Insurance Prospective Payment System (HIPPS) Skilled Nursing Facility Rate Code." Guide 005010X221 includes code HP (Health Insurance Prospective Payment System (HIPPS) Skilled Nursing Facility Rate Code) to meet the HIPPS business need.

Neither 4010 X091 nor 5010 X221 include any support for local health plan procedure codes.
Submission 10/5/2010
Status Date 10/21/2010
Status F - Final
Primary References
Document 005010X221
SectionSVC01
Page187
Set ID2110
Loop2110
Segment IDsvc
Element Position01