Journal Of The American Medical Association » American Association Of Medical Billers
Medical Billing - GD0 Record Fields 51 Through 56
If you're wondering why medical billing is so expensive and why medical costs themselves are sky high, this is our seventh installment in our series on electronic billing and the GD0 record. After we're finished with our review of the fields, which you will find in this article, we'll then discuss certain fields of the GD0 record, which need to be filled in based on the type of equipment that is being prescribed. If you thought it was confusing up to this point, you haven't seen anything yet.
GD0 field 51, position 200, is the leg elevation indicator. This indicator tells the carrier if the patient requires some sort of leg elevation. If the patient does require leg elevation then this field is filled with a Y. If not, this field is filled with an N.
GD0 field 52, position 201, is the patient's weight indicator. This field confuses a lot of billers. Reading the description, many billers think that the patient's weight is transmitted here, but seeing it is a one character field, they are totally confused. What is actually transmitted in this field is a one character code that tells the carrier if the patient's weight requires the patient to have a heavy duty wheelchair. This is quite common with patients who are very obese. If this is the case, the field is transmitted with a Y. If not, the field is transmitted with an N.
GD0 field 53, position 202, is the reclining wheelchair indicator. This indicator tells the carrier if the patient requires the reclining function with their wheelchair. The reason this has to be reported is because a standard wheelchair does not include this function and a carrier will not normally cover the reclining function unless it is medically necessary. If it is, this field is filled with a Y. If not, this field is filled with an N.
GD0 field 54, position 203, is the manual operation chair indicator. This indicator tells the carrier if the patient is able to operate a wheelchair manually. This is where a lot of billers get into trouble and fraud runs rampant. In order to sell higher end wheelchairs, many providers will set this field to N, meaning the patient cannot operate a manual wheelchair. Too many cases are found where this wasn't the case. This one field is probably one of the biggest problems with this CMN.
GD0 field 55, position 204, is the side transfer chair indicator. This indicator tells the carrier if the patient requires side transfer onto the chair. If this condition exists then the patient needs a certain kind of chair. This field verifies the medical necessity of that chair. The letter Y is transmitted if that is the case. If not, then the letter N is transmitted.
GD0 field 56, positions 205 - 320, is filler national and must be filled with spaces or the CMN and the claim will be denied.
In our next installment on medical billing, we'll begin our review of specific pieces of equipment and what fields need to be filled in for that equipment in relation to the GD0 record and CMN.
Michael Russell Your Independent guide to Medical Billing
Source: www.articlecity.com