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Back  RFI # 2109: 837P 12 DX codes 4 DX pointers

Formal vs. Informal Help Informal Formal

Submitter

Holly George

Description

If 12 diagnostic codes are used, should there be a diagnostic code pointer for each code on a service line? For example, you have DX codes 1 through 12 you have 12 service lines. Service line 1 points to DX code 1, service line 2 points to DX code 2, service line 3 points to DX code 3, service line 4 points to DX code 4, service line 5 points to DX code 5, service line 6 points to DX code 6, service line 7 points to DX code 7, service line 8 points to DX code 8, service line 9 points to DX code 9, service line 10 points to DX code 10, service line 11 points to DX code 11 and service line 12 points to DX code 12.

Is it incorrect to use 12 diagnostic codes and some DX codes do not have a service line that points to the DX code?

Submitter Assigned Keywords

Should there be a DX code pointer on at least one service line for each DX code

Response

The guide is silent on this question. Since there is no requirement, a diagnosis code does not need to be linked to a service line. These additional diagnosis codes are considered to be additional information.

It should be noted there is also no restriction preventing a submitter from linking multiple line items to a single diagnosis code.
Submission 10/30/2015
Status Date 12/15/2015
Status F - Final
Primary References
Document 005010X222
Section2300 HI
Page226
Set ID837P
Table2
Loop2300
Segment Position2310
Segment IDHI
Element Position12
Component Position02
Industry NameDiagnosis code
External Code List131 (for ICD-9)
Code ValueAll