Medical Billing - GU0 Record Fields 1 Through 7

By: Michael Russell
Submitted: 2007-01-17 15:35:55
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In the world of medical billing, there is no CMN more dreaded by billers than the DMEPOS CMN. This grandaddy of all CMNs is over 70 fields long. You practically need to be a certified medical practitioner to understand it to begin with. In the following series of articles, we're going to cover the various fields of this monster of a CMN. If there is something you're not clear on, consult your manual or call your carrier for complete instructions on how to fill out the field in question. So, if you're ready, hang onto your brain cells because you are going to need them for what's to follow.

First of all, it is important to know what DMEPOS stands for. It is an acronym for Durable Medical Equipment, Prosthetics, Orthotics and Supplies. In other words, this CMN covers just about everything under the sun related to those three categories. That is the reason why this CMN is so long. It needs to be able to handle a number of items. We'll begin with field number 1.

GU0 field 1, positions 1 - 3, is the record type. This must be filled with GU0 and most come after all F records for this patient in the claim file. Also, if other CMNs are being transmitted, it must come after all CMNs from GA0 to GP0.

GU0 field 2, positions 4 - 5, is the sequence number. This is the number of the CMN in the claim file. There can be up to 99 CMNs transmitted with a claim file. So each record would be GU0-01, GU0-02 and so on.

GU0 field 3, positions 6 - 22, is the patient control number. This field must contain the same patient ID number that is transmitted in the CA0 record and all subsequent records that also transmit this information.

GU0 field 4, position 23, is the cert type. This field tells the carrier if the CMN is an initial, designated with a 1, a recert, designated with a 3, or a revised, which is designated with a 2. One of those codes must be entered. The field cannot be left blank.

GU0 field 5, positions 24 - 25, is the place of service. This field tells the carrier where the actual service is performed. This must match the info transmitted in the FA0 record field number 7.

GU0 field 6, position 26, is the replacement item field. This field tells the carrier if the item this CMN is for is a replacement item or not. If it is, a Y is entered. Otherwise, you enter an N. This must be entered for all CMNs except DMERC 8.02. For that CMN, this field must be blank.

GU0 field 7, positions 27 - 31, is the HCPCS procedure code. This field tells the carrier what the procedure code is for the item this CMN is prescribing.

In our next installment of medical billing, we'll continue with our review of the GU0 record, picking up with field number 8.

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