Medical Billing - GP0 Record Fields 8 Through 14

By: Michael Russell
Submitted: 2007-01-17 15:35:55
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Medical billing of parental nutrition claims, as with enteral nutrition claims is relatively new in comparison to other billable services. The parental nutrition CMN is electronically transmitted using the GP0 record. In this installment we're going to cover the GP0 record, starting with field number 8.

GP0 field 8, positions 42 - 43, is the number of months of this certification. This field tells the carrier how long this CMN is going to be good for. An initial CMN is usually good for about 3 months. After the initial expires, the first recertification is usually for 9 months. After that, each recertification is usually for a year. There are of course exceptions.

GP0 field 9, positions 44 - 51, is the date last seen by physician. This field tells the carrier when the last date it was that the physician who prescribed this CMN saw the patient. If the period of time is too long before the certification, the CMN may be denied by the carrier.

GP0 field 10, position 52, is the non-physician visit indicator. This field is identical to the indicator for enteral nutrition claims. This tells the carrier what the medical evaluation of the patient was based on. There are only four possible entries. An N is entered if the evaluation was made by a visiting nurse. An L is entered if the evaluation was made by lab or clinical reports. An O is entered if the evaluation was made by other means. The field is left blank if it is not applicable.

GP0 field 11, positions 53 - 55, is the patient's age. This tells the carrier how old the patient is in years. Enough space is left should the patient be over 100 years old. If however the patient is under 100, the field must be left zero filled. In other words, an age of 72 would be transmitted as 072.

GP0 field 12, positions 56 - 58, is the patient's height. This field tells the carrier how tall the patient is in inches. If the patient is under 100 inches, which is more likely than not, then the field must also be left zero filled. A height of 72 inches, or six feet, is transmitted as 072.

GP0 field 13, positions 59 - 61, is the patients weight. This field tells the carrier how much the patient weighs in pounds. If the patient is under 100 pounds the field needs to be left zero filled. A weight of 99 pounds would go over as 099.

GP0 field 14, position 62, is the level of consciousness indicator. This field tells the carrier what the patient's level of consciousness is. There are two possible entries for this field. C is entered if the patient is conscious and an I is entered if the patient is conscious impaired.

In our next installment of medical billing, covering electronic submission of claims and the GP0 record, we'll be covering the parental CMN picking up with field number 15.

Article source: Expert Articles