Medical Billing - FA0 Record Fields 19 Through 28

After reading an entire review of FA0 record field number 18 for medical billing of claims via electronic media, you're probably hoping to get a little bit more information in this installment. Not a problem. We pick up with field number 19.

FA0 field 19, positions 86 - 89, is Anesthesia Minutes. While this field is hardly ever used, when it is used it's to send the number of minutes to be billed for a patient who was put under anesthesia for a particular procedure. The reason for this is that the anesthesiologist is paid for his time.

FA0 field 20, position 90, is the emergency indicator. This field needs to be filled in if the patient was admitted to emergency. There is special billing for this.

FA0 field 21, position 91, is the COB indicator. COB stands for coordination of benefits. This field needs to be filled in if the patient does have COB. In most cases, unless the patient has no insurance, this is filled in.

FA0 field 22, position 92, is the HPSA indicator. HPSA stands for Health Professional Shortage Area. This is an area, usually in poverty zones, where they have a shortage of health care. This indicator needs to be filled in if this is a claim for HPSA.

FA0 field 23, positions 93 - 107, is the rendering provider ID. This is the provider who actually provided the services to the patient, such as the doctor. This field must be filled in or the claim will be denied.

FA0 field 24, positions 108 - 122, is the referring provider ID. Unless you're being treated by your primary physician, most procedures that are done are referred to by that general practitioner. The referrer ID of that physician must be filled in here if there was indeed a referral. This is a conditional field.

FA0 field 25, positions 123 - 124, is the referring provider state. This is the two character state code of the referring provider if there was one.

FA0 field 26, position 125, is the purchase service indicator. This is checked off to show the payer that a service was purchased rather than an actual item.

FA0 field 27, positions 126 - 132, is the disallowed cost containment amount. Keeping this explanation simple, this is the amount of the charges that are not allowed, or not covered. For example, let's say there is a procedure for $100 that includes some kind of additional procedure that is $25. If that additional procedure is not covered then even though the claim is billed for $125, the allowed amount will be $100 and therefore the disallowed cost containment amount will be $25.

FA0 field 28, positions 133 - 139, is the disallowed other amount. This field is for reporting any additional disallowed costs that can't be reported in field 27. The reasons for this are beyond the scope of this article.

In our next installment of medical billing of electronic claims, we'll pick up with FA0 field number 29.

Article Source: http://www.content.onlypunjab.com

Michael Russell Your Independent guide to Medical Billing

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