[ Friday, January 02, 2004 ]


Some clean-up items:

CMS recently announced the top 9 problems in TCS usage, noting that half of all electronic claims for Medicare have some defect from the pure X12 standard. The top problems:

Errors in the provider's SS# or Tax ID number (data element NM109);
Enveloping isues with ISA and GS segments;
Invalid taxonomy codes;
Invalid characters in the data stream (software problems?);
Missing subscriber data elements, such as date of birth or gender;
Missing or incorrectly coded address information (data elements N3 and N4);
Missing contact phone number of person submitting claim;
Sending billing provider and rendering provider loops when they are the same entity; and
Invalid date formats.

I don't know what several of those are, but it looks like billing software hasn't kept pace with where it needs to be for HIPAA TCS compliance.

Jeff [5:10 PM]

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