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Back  RFI # 1554: Product/Service ID Qualifier

Formal vs. Informal Help Informal Formal

Submitter

Jerri Bollinger

Description

In reference to Version 5010 X223 837I TR# page 425 Loop 2400 SVD202-1 data element 235 specifically with product/service ID qualifiers HC and HP. Our billing software vendor is requiring the presence of the "HP" product /service ID quailifer when the SV201 equals revenue codes 022X, 023X or 024X. Does the HP qualifier apply to only skilled nursing (022X) or should it exist when 022X,023X or 024X exist? Per TR3 Page 425 HP- Health Insurance Prospective Payment System(HIPPS) Skilled Nursing Facility Rate Code
CODE SOURCE 716: Health Insurance Prospective Payment
System (HIPPS) Rate Code for Skilled Nursing Facilities.
Please advise

Submitter Assigned Keywords

Data Element 235 Code Source 716

Response

The HP qualifier should be used when the code reported in the SVD202-2 is from the referenced code list. It is valid to use a HIPPS code when the revenue code is 0022, 0023, and 0024.
Submission 3/29/2012
Status Date 6/5/2012
Status F - Final
Primary References
Document 005010X223
Section1.4
Page425
Loop2400
Code ValueHP