Medical Billing - GU0 Record Fields 8 Through 17

By: Michael Russell
Submitted: 2007-01-17 15:35:55
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Medical billing can be a real nightmare. No wonder the turnover with medical billers is so great. Between the number of regulations, pile of forms and tons of red tape, it's enough to make anybody crazy. One of the worst culprits is the DMEPOS CMN, or the GU0 record, which is used for electronic transmission of claims using NSF 3.01 specifications. In this installment, we'll be covering the GU0 record, picking up with field number 8.

GU0 field 8, positions 32 - 33, is the HCPCS modifier. The HCPCS modifiers are one of the big reasons that medical billers lose their minds so quickly. Having to keep track of which modifier goes with what month can be a real pain in the backside. Fortunately, most electronic billing software packages take care of this for you. This field is used to tell the carrier which month of billing you're in for the item or service in question.

GU0 field 9, position 34, is the warranty reply field. This field tells the carrier if the item being billed for this CMN is under warranty or not. If it is, the field is transmitted as a Y. If it isn't, it is transmitted as an N. If this doesn't apply, then the field is transmitted as a D.

GU0 field 10, positions 35 - 36, is the warranty length. If the item is under warranty, as designated by field number 9, then this field tells the carrier what the warranty period is in months.

GU0 field 11, position 37, is the warranty type. This field tells the carrier what type of warranty the item comes with. There are four valid entries for this field. A 1 is entered if the item comes with a full replacement warranty. A 2 is entered if the item comes with a pro rated replacement. A 3 is entered if the item comes with a parts and labor warranty. A 4 is entered if the warranty is for parts only. This field must be entered if required by the payer.

GU0 fields 12 - 15, positions 38 - 57, are the diagnosis codes. These fields tell the carrier what the diagnosis codes are, related to the piece of equipment that the CMN has been issued for. At the time of this writing, these are still ICD-9 codes and not the new ICD-10 codes. That may change at any time.

GU0 field 16, positions 58 - 59, is the patient height. This field tells the carrier what the patient height is in inches. Unlike many of the other height fields in the NSF specifications, this field is only two characters in length.

GU0 field 17, positions 60 - 62, is the patient weight. This field tells the carrier what the patient weight is in pounds. If the weight is under 100 pounds then the field is sent left zero filled. For example, 99 pounds is transmitted as 099.

In our next installment on medical billing, we'll be covering the GU0 record picking up with field number 18.

Michael Russell

Your Independent guide to Medical Billing

Article source: Expert Articles

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