Medical Billing - EA0 Record Fields 10 Through 19

By: Michael Russell

Continuing with our series on medical billing claims via electronic means, we're going to cover the EA0 record, picking up with field number 10, which provides more information to the payer about the accident, if there was one, in relation to the claim and the condition of the patient.

EA0 field 10, positions 40 - 41, is the accident state. This is a two character state code that tells the payer in which state the accident occurred. This is important because each state has different laws regulating accident cases pertaining to medical billing of claims.

EA0 field 11, positions 42 - 43 is the accident hour. This is a two digit time that must be reported in military time. In words, 9 AM would be reported as 09 and 9 PM would be reported as 21 for 21 hundred hours. Minutes are not reported. If the accident took place before the half hour, round down. If after the half hour, round up.

EA0 field 12, position 44, is the abuse indicator. This is an indicator that tells the payer if the condition was caused by abuse such as spousal abuse or parental abuse. This is needed for legal reasons in case the claim has to go to court.

EA0 field 13, position 45, is the release of information indicator. This is an indicator that tells the payer that information is allowed to be released to other people. This is important because of the privacy laws regarding patient files. Unless this is marked off, no records can be given to anyone outside of the attending physician.

EA0 field 14, positions 46 - 53, is the release of information date. This is the actual date that the patient or guardian signed off that information can be shared. If any information was shared prior to this date, it could be grounds for legal action.

EA0 field 15, position 54, is the same of similar condition indicator. This tells the payer that the condition that the patient is suffering from is the same or a similar condition to a pre-existing one. This is also important in case of lawsuits when trying to prove that a condition was caused by an accident.

EA0 field 16, positions 55 - 62, is the same of similar condition date. This is the date when the original condition was first diagnosed. This is to show how long it has been that the patient has been suffering with this condition, again, in case there are legal issues involved.

EA0 field 17, position 63, is the disability indicator. This tells the payer if the patient is disabled. There are only three things that can go here. Either T for total, P for partial or blank for no disability.

EA0 fields 18 and 19, positions 64 - 79. These are the disability date fields, from and to respectively. The to field is only filled in if the disability was temporary. If the disability is permanent or is still in effect, then this field is left blank.

In our next installment in this series on medical billing of claims electronically, we're going to pick up with EA0 record field number 20.