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If you've been following our medical billing series on oxygen billing and the electronic transmission of claims using NSF 3.01 specifications, you probably have been thinking, at least to this point, that this GX0 record isn't too bad. Well, that's all about to change as we start getting into the more complex fields of this record with this installment. We pick up our review of the GX0 record with field number 20, which is going to take a little bit of explaining in order to make it perfectly clear.GX0 field 20, position 146, is the inpatient/outpatient indicator. You have to wonder how the carriers come up with these descriptions because this one does absolutely nothing to clarify exactly what this field is for. This indicator is a simple Y or N answer, for yes or no. But it's not to tell the carrier if the patient was an inpatient or an outpatient at the facility. This indicator is used to tell the carrier if the tests reported in fields 22 or 23 were performed exactly within one day of discharge from the inpatient facility or if the tests were performed while the patient was at home while in a chronic stable state. If you don't understand what that means, that's okay. You are not alone. For clarification of the second part of this explanation, consult with your carrier. If you can answer yes to either of those conditions, then a Y is transmitted to the carrier. If you can't answer yes to either of those conditions then an N is transmitted to the carrier.GX0 field 21, positions 147 - 211, is filler. Usually, filler is thrown it at the end of a record when there is no more data to report. So why put filler in the middle of a record when there is more data to submit? For those of you who have been scratching your head wondering they why of this, the answer is finally here. The reason is because the data that follows was intended to be mapped to coincide with other related fields from other CMNs. As it turned out with NSF 3.01 specifications, this never happened. So the result is that we have a lot of wasted space in the middle of a record that has everybody, billers especially, totally confused. Let's hear it for NSF regulations.GX0 field 22, positions 212 - 214, is the arterial blood gas. This is a three digit field with an implied decimal. Valid values are from 00.0 to 99.9. This field tells the carrier what the arterial blood gas results were that were taken on or before the date of this certification.GX0 field 23, positions 215 - 217, is the oxygen saturation. This field is similar to the one above as it is also a three digit field with an implied decimal. However, this field tells the carrier what the oxygen saturation tests results were on or before the date of this certification.In our next installment on medical billing, we'll be covering the GX0 record, picking up with field number 24.
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Michael Russell
Your Independent guide to Medical Billing
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