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  1. FHIR Specification Feedback
  2. FHIR-45348

Query on productOrService under Item in PAS Bundle

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    • Resolution: Considered - Question answered
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    • US Da Vinci PAS (FHIR)
    • 2.0.1
    • Financial Mgmt
    • PAS Claim
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      X12 currently allows the following codes which is reflected in our value set:

      HCPCS CPT
      ICD-9-CM
      ICD-10
      NDC

      and an X12 specific set of codes (UM03).

      The codes that you listed are found in the X12 codes, so are allowed. It is not a requirement that you use CPT, so it is possible to use the service-type codes. UM03 in the X12 guide lists the service-type codes that are allowed.

      At this time, the value set includes the Service Type codes, so if the code is a Service Type code, then it is mapped to the UM03. If the code is from the other code systems, then it would go in the SV101 or SV202.

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      X12 currently allows the following codes which is reflected in our value set: HCPCS CPT ICD-9-CM ICD-10 NDC and an X12 specific set of codes (UM03). The codes that you listed are found in the X12 codes, so are allowed. It is not a requirement that you use CPT, so it is possible to use the service-type codes. UM03 in the X12 guide lists the service-type codes that are allowed. At this time, the value set includes the Service Type codes, so if the code is a Service Type code, then it is mapped to the UM03. If the code is from the other code systems, then it would go in the SV101 or SV202.

      Question: 

      For some programs like LTAC (Long term acute care), SNF (Skilled Nursing Facility), there are no CPT codes. We have Service Types codes for these programs like for LTAC, its 54 and for SNF, its AG.

      Can we use only Service-type codes instead of Billing codes for PAS.Claim.Item.productOrService?

            Unassigned Unassigned
            poonam.dhingra@evicore.com poonamDhingra
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