RFI Browser

Back  RFI # 2136: Telemedicine use of Code E37

Formal vs. Informal Help Informal Formal

Submitter

Amy Wiener

Description

I would like to request clarification to RFI 1957 - Telemedicine
Can it be included that although the code of E37 is available it is not in use until 6010 is implemented?

http://www.wpc-edi.com/reference/codelists/healthcare/health-care-service-type-codes/

Health Care Services Type Codes • ASC X12 External Code Source 958LAST UPDATED 3/1/2016
Health Care Service Type Codes are used to identify the classification of service or benefits. This external code list is for use in ASC X12 Transaction Sets 270, 271 and 278, versions 006010 and higher. Version 005010 codes are available within the ASC X12 TR3 Implementation Guide.


I believe that this will provide clarification for providers and payers

Thank you

Submitter Assigned Keywords

telemedicine, E37, RFI 1957

Response

The health care service type code E37 is not available for use in the 005010X279 Health Care Eligibility Benefit Inquiry or the 005010X217 Healthcare Care Service Review.

Recommendation

As stated in RFI 1957, when reporting telemedicine use a suitable existing EB03 code from the 005010X279 guide, such as ‘3 Consultation’ in conjunction with the MSG segment (element MSG01) providing the information that the service is telemedicine, e.g. MSG*TELEMEDICINE BENEFIT.

For the 005010X217 Healthcare Care Service Review, telemedicine should be reported in loop 2000F as a procedure code in the SV1, SV2, or SV3 as appropriate
Submission 3/18/2016
Status Date 4/25/2016
Status F - Final
Primary References
Document 005010X279
Section2.5.1
Page289
Set ID271
Loop2110C
Segment Position1300
Segment IDEB
Element Position03