Medical Billing - FA0 Record Fields 56 Through 66

By: Michael Russell
Submitted: 2007-01-17 15:33:56
Print this article | Tell a friend | For publisher |

Rating:

 

In the longest of our series on electronic billing of medical claims, we have finally come to the end of our review of the FA0 record, which just happens to be the longest record in the NSF 3.01 specifications. This last installment will cover fields 56 through 66. After this, we will move on to the FB0 record, which is more line item detail.

FA0 field 56, positions 274 - 283, is the provider phone. This may seem simple enough but it is anything but. The phone number entered here must be the number where the actual provider can be reached. Some providers have home offices in one location and operating facilities in other locations. Unless the procedure took place at the home office, the number entered here must be the number at the facility where the patient was treated. This is in case the provider has to be reached for whatever reason.

FA0 field 57, position 284, is the performing provider tax type. This is a one character code that designates the tax status of the physician. This is important because should the physician work at a clinic that is tax exempt, then his status would be the same as the clinic's is.

FA0 field 58, positions 285 - 293, is the performing provider tax ID number. If the physician does have tax-exempt status, this number will verify that. It must be transmitted so that the payer will know how to handle the claims as far as any taxes that are charged.

FA0 field 59, position 294, is the performing provider assignment indicator. This simply tells the payer or carrier if the provider is accepting assignment or not. In other words, will accept the fee schedule set forth by the payer.

FA0 field 60, position 295, is the pre-transplant indicator and is not supported.

FA0 field 61, positions 296 - 302, is the ICD-10-PCS. ICD-10-PCS is the replacement for the old ICD-9 coding system. All the codes in the ICD-10-PCS system are alpha codes. These codes are used to identify the actual procedure that was performed. To get a list of valid codes, check with your ICD-10-PCS manual.

FA0 field 62, positions 303 - 316, is the universal product code. These are the same UPC codes that we find on practically every grocery item we buy at the local supermarket. Every procedure or item now comes with its own UPC code and it needs to be transmitted here if it exists. This is an optional field. Most providers don't bother sending it.

FA0 fields 63 - 66, positions 317 - 320, are the diagnosis pointers for diagnosis 5, 6, 7 and 8. These need to be filled in for each diagnosis that is entered beyond the first four, if they exist.

You will notice that there is no national filler in this record. The reason is because this is the longest record and all 320 characters are used. That is why we have filler in all the other records because each record needs to be the same length.

This concludes our review of the FA0 record for medical billing of electronic claims. In our next installment we'll begin going over the FB0 record.

Article source: Expert Articles