RFI Browser

Back  RFI # 1485: 835 duplicate modifier

Formal vs. Informal Help Informal Formal

Submitter

Julia Dunicheva

Description

Is it complaint with the TR3 to send same procedure modifier code in 2110\SVC01 composite multiple times? i.e. provide the same code in both SVC01-03 and SVC01-04.

Response

External code sets are maintained by entities other than ASC X12 as indicated by the code source in the TR3. The code source is listed with each applicable data element and additional reference is provided in Appendix A. The values for an external code set are specified by the organization responsible for maintaining that code set. Each code set is valid within the dates specified by the organization responsible for maintaining that code set.

For HCPCS, code source 130 states that CMS maintains this code set. Therefore, it is CMS, not ASC X12, that specifies valid modifier values and combinations.
Submission 12/29/2011
Status Date 3/6/2012
Status F - Final
Primary References
Document 005010X221
Section2.4
Set ID835
Loop2110
Segment IDSVC
Element Position01
Component Position04