The endless road that is medical billing and trying to make heads or tails of CMNs, is enough to drive even the most sane of us totally out of our minds. It seems that there is a CMN for every possible item. Some CMNs are fairly simple to understand and then there are those, like the DMEPOS CMN, or as is known in electronic billing circles as the GU0 record, that are about as convoluted and confusing as they come. This is now our tenth installment on the GU0 record with no end in site. It's no wonder medical billers are frustrated. We pick up our review of the GU0 record with field number 62.
GU0 field 62, positions 266 - 269, is Reply NUM L04 N01. This field is the reply to the first question on any DMERC certification requiring a four position numeric response. The following forms are supported for this field. For forms 02 and 09, the valid responses are 0001 - 0024. For forms 03, 08 and 10, the valid responses are 0000 - 9999. For form 04, the valid responses are 0001 - 0099. For form 06, the valid responses are 0001 - 0099. However, these responses are only valid if field GU0-27 is filled with N or D. Forms 01 and 05 are reserved for future use.
Further clarification is needed for these values. For form 02, this is the number of hours in the day that the patient spends in a wheelchair. For form 03, this is the number of episodes of sleep apnea during testing that last for ten seconds or more. For form 04, this is the number of months prior to ordering the device that the patient sustained the fracture. For form 06, this is the number of months that the patient has been in considerable pain. For form 08, this is the milligram dosage of the drug being given to the patient. For form 09, this is the number of hours during the day that the patient is infused with the drug. Form for 10, this is the milliliters per day that the patient is given the amino acid.
For those who need to know where these actual questions come from, here is a brief explanation and mapping. For form 02, the question is number 5 from that form. For form 03, the question is number 12 from that form. For form 04, the question is number 6.B from that form. This is an osteogenesis stimulator CMN. For form 06, the question is number 4 from that form. For form 08, the question is number 1.B from that form. For form 09, the question is number 6 from that form. And finally, for form 10, the question is number 4.A from that form.
As you can see, it can take quite a bit of time and space to explain even one field of the GU0 record. This is why medical billing is so confusing, complicated and ultimately, so expensive. If the process could be simplified, maybe medical costs would come down a bit, at least from the billing end.
In our next installment on medical billing, we'll pick up with the GU0 record and field number 63.
Michael Russell Your Independent guide to Medical Billing |
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