Uploaded image for project: 'FHIR Specification Feedback'
  1. FHIR Specification Feedback
  2. FHIR-35735

isn't 5010 the current version?

    XMLWordPrintableJSON

Details

    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Highest Highest
    • US CARIN Blue Button (FHIR)
    • 1.2.0
    • Financial Mgmt
    • Artifacts Summary
    • 7
    • Hide

      The HTA page for this Code System has been updated via https://jira.hl7.org/browse/HTA-86 

      Update the text in the and CMSPlaceofServiceCodes Code System and CMSPlaceofServiceCodes ValueSet

       

      "Place of Service Codes are two-digit codes placed on health care professional claims to indicate the setting in which a service was provided. The Centers for Medicare & Medicaid Services (CMS) maintain POS codes used throughout the health care industry.

       

      This code set is required for use in the implementation guide adopted as the national standard for electronic transmission of professional health care claims under the provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). HIPAA directed the Secretary of HHS to adopt national standards for electronic transactions. These standard transactions require all health plans and providers to use standard code sets to populate data elements in each transaction. The Transaction and Code Set Rule adopted the ASC X12N-837 Health Care Claim: Professional, volumes 1 and 2, as the standard for electronic submission of professional claims. This standard names the POS code set currently maintained by CMS as the code set to be used for describing sites of service in such claims. POS information is often needed to determine the acceptability of direct billing of Medicare, Medicaid and private insurance services provided by a given provider."

       

       

       Note that this has been updated here: https://confluence.hl7.org/pages/viewpage.action?pageId=97455044

       

      Show
      The HTA page for this Code System has been updated via https://jira.hl7.org/browse/HTA-86   Update the text in the and CMSPlaceofServiceCodes Code System and CMSPlaceofServiceCodes ValueSet   "Place of Service Codes are two-digit codes placed on health care professional claims to indicate the setting in which a service was provided. The Centers for Medicare & Medicaid Services (CMS) maintain POS codes used throughout the health care industry.   This code set is required for use in the implementation guide adopted as the national standard for electronic transmission of professional health care claims under the provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). HIPAA directed the Secretary of HHS to adopt national standards for electronic transactions. These standard transactions require all health plans and providers to use standard code sets to populate data elements in each transaction. The Transaction and Code Set Rule adopted the ASC X12N-837 Health Care Claim: Professional, volumes 1 and 2, as the standard for electronic submission of professional claims. This standard names the POS code set currently maintained by CMS as the code set to be used for describing sites of service in such claims. POS information is often needed to determine the acceptability of direct billing of Medicare, Medicaid and private insurance services provided by a given provider."      Note that this has been updated here: https://confluence.hl7.org/pages/viewpage.action?pageId=97455044  
    • Corey Spears / Rachel Foerster : 7-0-2
    • Clarification
    • Non-substantive

    Description

      In description of CMS POS codes, it says that 4010 is the version for the professional claim, but isn't 5010 the mandated version?

      Attachments

        Activity

          People

            Unassigned Unassigned
            celine_lefebvre Celine Lefebvre
            Celine Lefebvre
            Watchers:
            2 Start watching this issue

            Dates

              Created:
              Updated:
              Resolved: