Medical Billing - GE0 Record Fields 21 Through 30

By: Michael Russell
Submitted: 2007-01-17 15:35:54
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If you've been following our series on medical billing and the GE0 record for electronic claims submission using NSF 3.01 specifications, we're exactly two-thirds of the way through with our review of the GE0 record. We pick up, in this installment with field number 21 for enteral nutrition billing.

GE0 field 21, positions 86 - 89, is the calories product 1 field. This field tells the carrier how many calories per day the patient is to be getting from product 1. Many people wonder why this is broken down this way. The answer is simply that some patients are actually prescribed multiple products which each one having a different calorie requirement.

GE0 field 22, positions 90 - 94, is the HCPCS procedure code field. This field tells the carrier the procedure code that is associated with this product. Even though there is a procedure code transmitted with the F record, the CMN itself also must have a procedure code transmitted.

GE0 fields 23 and 24, positions 95 - 98, are the HCPCS modifier codes. These are codes which essentially tell the carrier which month of billing it is for this item. The software should be programmed to recognize this and create the proper code on the fly without the biller having to enter it.

GE0 field 25, positions 99 - 101, is the enteral frequency field. This field tells the carrier how many times per day the patient needs to be fed.

GE0 field 26, positions 102 - 201, is the narrative field. As was explained in subsequent installments, this field is used for a variety of reasons. Basically and according to the official Medicare handbook, this field is to be used "to describe special circumstances, medical justification or any additional comments necessary for proper adjudication of the claim". In other words, just about anything can go here. However, you are limited to 100 characters, so keep it short.

GE0 field 27, positions 202 - 216, is the product name 2 field. This field tells the carrier the name of the second product that the patient needs. If the patient only needs one product then this field is left blank.

GE0 field 28, positions 217 - 220, is the calories of product 2 field. This field tells the carrier how many calories per day the patient is to be given from product 2. If no product 2, then this field is left blank.

GE0 field 29, positions 221 - 223, is the frequency of product 2 field. This field tells the carrier how many times the patient needs to be fed product 2. If there is no product 2 then this field is left blank.

GE0 field 30, positions 224 - 320, is filler national. This field must be filled with spaces or the claim will be denied.

Just a brief note before concluding this installment. When prescribing multiple products, the total calories and feedings cannot exceed the total calories and feedings of the CMN as prescribed.

In our next installment of medical billing, we'll cover another in our long line of CMNs.

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