Medical Billing - FA0 Record Fields 39 Through 47

The fields we're going to cover in this installment of medical billing of electronic claims, using NSF 3.01 specifications, are of absolutely no use to anyone. That's right. They are not supported by any payer in the system. So the question you have to ask is "why"? Why waste all that space when maybe it could have been used for something productive? Certainly we don't have enough red tape when it comes to medical billing, so why have nine fields that serve absolutely no purpose? Well, we're not going to try to answer that question here because the truth is, nobody has an answer for it. What we are going to do is try to explain what is keeping the makers of the NSF specifications from removing these fields and replacing them with something that is actually worthwhile.

We should probably start off with the names of these nine fields, which are Podiatry Therapy Type, Hospice Provider, HGB/HCT Date, Hemoglobin Result, HCT Result, Patient Weight, Epotin Dosage, Serum Creatine Date and Creatine Result. We're not even going to bother explaining what these fields are for, except you're probably wondering what HGB and HCT stand for. They stand for hemoglobin and hemocrit. These are related to your blood. Leave it at that. So why aren't these fields used?

When the NSF specifications were created, everybody had some high expectations on what information would be transmitted using these specifications. So a number of fields were included in the original specifications, in the hopes that this information would be available for transmission. Well, theory is always a lot cleaner than actual practice and for whatever reason, it just wasn't feasible to transmit this information electronically. So the specifications were made but afterwards certain fields were designated as not supported. So why not just remove them? Here comes the problem with computers and medical billing.

Each record is transmitted as one long string of characters. Even though they are logically delimited, they are still physically all together. By removing fields 39 through 47, you would be basically putting field 48 after field 38 and while the human eye would have no trouble seeing this, the software program created to read this record would not know that field 48 came after field 38 and would reject the claim because nothing would be where it was supposed to be.

It is still hoped that someday these fields that are currently not supported will actually be used and make it so that all claims can be sent electronically. As it stands now, claims that require this information have to be sent on paper because even if a software program was to fill in fields 39 through 47, the reading program on the payer end would not recognize it and would reject the claim anyway.

While electronic billing is more efficient than paper medical billing, it is still not perfect. Hopefully, the day will come when all the fields in the NSF 3.01 specifications are actually used and we can save a little money on our out of control medical costs.

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Michael Russell Your Independent guide to Medical Billing

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