Medical Billing - GP0 Record Fields 1 Through 7

By: Michael Russell
Submitted: 2007-01-17 15:35:53
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In addition to enteral nutrition claims for medical billing, there are also claims that fall under the category of parenteral nutrition. These claims are sent using GP0 records instead of GE0 records. The first question that many people ask is what the difference is between enteral nutrition and parental nutrition. So before we go into the GP0 CMN in detail, a brief explanation of the differences between the two is probably in order.

Enteral nutrition is where the feeding of the patient is done through feeding tubes. The food still goes through the patient's digestive system, including the stomach. With parental nutrition, the method of feeding is done by intravenous. The food totally bypasses the digestive system. This type of feeding is usually done with patients who have just had surgery and can't have any food go through their stomach. It is also done in cases where the patient is critically ill. Having cleared that up, we'll now go into our detailed review of the GP0 record.

GP0 field 1, positions 1 - 3, is the record type. This field is to be filled with GP0. Note: This record must come after the F records for this patient and claim. Failure to do this will result in the claim being denied.

GP0 field 2, positions 4 - 5, is the sequence number. This is the number of the CMN itself. There can be as many as 99 CMNs sent with a claim. Each one would be designated as GP0-01, GP0-02, etc.

GP0 field 3, positions 6 - 22, is the patient control number. This must be the same patient ID number that is transmitted in the CA0 record and all subsequent records containing a patient ID.

GP0 field 4, position 23, is the certification type. For parental nutrition, there can be three valid responses. If this is an initial certification, this field goes over as an I. If it is a renewal certification, it goes over as an R. If it is a revised certification, it goes over as an S.

GP0 field 5, positions 24 - 31, is the date therapy began. This is the actual date that the patient began parental therapy. The date can go over as yyyymmdd or mmddyyyy, depending on the requirements of the carrier.

GP0 field 6, positions 32 - 33, is the therapy duration field. This field tells the carrier the estimated time that the patient will be on parental nutrition. It should be noted that even though this is just an estimate, the field must still be filled in.

GP0 field 7, positions 34 - 41, is the last date of certification field. This field tells the carrier the last date that this CMN was certified prior to this. The date can go over as yyyymmdd or mmddyyyy, depending on the requirements of the carrier.

In our next installment of medical billing using electronic transmission media and NSF 3.01 specifications, we'll be continuing our review of the GP0 record, picking up with field number 8.

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