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Back  RFI # 1629: Revenue Codes & Modifiers

Formal vs. Informal Help Informal Formal

Submitter

BCBSIL HCSC

Description

Would the following be a compliant use of the SVC segment using the SVC01-1 = NU ?

SVC*NU:0079:QK*2604*248.01****1~

It's our understanding that Revenue Codes do not have modifiers (SVC01-3) and that would indicate that an NU with a product/service ID and a modifier would be an invalid/incorrect use of the NU qualifier.

Is our understanding correct?

Submitter Assigned Keywords

Revenue Codes and Modifiers

Response

Modifiers apply to CPT and HCPCS Level II codes, which would be identified in the 005010X212, SVC01-01 with the qualifier ‘HC – Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes’. Modifiers are not reported with Revenue Codes as evidenced by the SV2 Segment of the 837 Institutional Guide. Since modifiers are not submitted in conjunction with Revenue Codes on the claim, it would be inaccurate and not consistent with the guide to report modifiers with a Revenue Code in the Claim Status Transaction.
Submission 7/17/2012
Status Date 9/10/2012
Status F - Final
Primary References
Document 005010X212
Section3
Page198
Set ID276
Table2
Loop2220D
Segment PositionC003
Segment IDSVC
Element Position01
Component Position1
Industry NameProcedure Identifier
External Code ListNUBC Revenue Codes
Code ValueNU
Secondary References
RFI ID 2091
Document 005010X212
Section3
Page198
Set ID277
Table2
Loop2220D
Segment PositionC003
Segment IDSVC
Element Position01
Component Position3
Industry NameProcedure Modifier