Medical Billing - GE0 Record Fields 9 Through 14

When doing medical billing of claims through electronic transmission media, the GE0 record is fairly new as enteral nutrition wasn't always something that was billable. In this installment of our GE0 CMN series, we cover fields 9 through 14.

GE0 field 9, positions 44 - 51, is the date last seen field. This field tells the carrier the last time the patient saw the physician who issued this CMN. The reason this is needed is because with some items it is required that a patient see his or her doctor every so many days. If this isn't done, there is a possibility the claim could be denied because the carrier could claim the patient hasn't proven the continued need for the item. This date is transmitted in yyyymmdd or mmddyyyy format, depending on the requirements of the carrier.

GE0 field 10, position 52, is the non-visit indicator. Many billers have no idea what this actually means. This field tells the carrier what the medical evaluation of the patient was based on. There are four possible code responses. N means the evaluation was made by a visiting nurse. L means the evaluation was made by lab tests or clinical reports. O means the evaluation was made by some other means and if the field is left blank, it means it does not apply to this particular claim. It should be noted that if the physician didn't see the patient during this certification then this must be noted in the narrative field 26, which we will cover in another installment.

GE0 field 11, positions 53 - 55, is the patient age. Many people wonder why this is a three digit field. Well, believe it or not, some people do live to be 100. If the patient is under 100 then the field is zero filled to the left. So a patient who is 65 is sent over as 065.

GE0 field 12, positions 56 - 58, is the patients height in inches. While it is true that a patient would have to be over 8 feet tall to be 100 inches, nevertheless the field does allow for a patient to be that tall. You'd be surprised how many billers feel this is a total waste of transmission space.

GE0 field 13, positions 59 - 61, is the patients weight in pounds. This field tells the carrier how much the patient weighs. For enteral nutrition, this field is critical because how much nutrition a patient needs is greatly determined by his or her weight. Many patients who suffer from malnutrition are actually given more than a patient who is heavier.

GE0 field 14, position 62, is the consciousness level indicator. This field tells the carrier the level of the patient's consciousness. There are only two valid responses. C is entered if the patient is conscious and the letter I is entered if the patient is conscious impaired.

In the next installment on medical billing, we'll cover the GE0 record, picking up with field number 15.

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Michael Russell Your Independent guide to Medical Billing

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