| In our previous installment on medical billing, we | | | | began field. This is the date that enteral nutrition |
| covered the basics of enteral nutrition and billing | | | | therapy for the patient began. The format for |
| and how it got to be such big business. In this | | | | this date is either yyyymmdd or mmddyyyy, |
| installment we're going to review the GE0 record, | | | | depending on the requirements of the payor. |
| fields 1 through 8, which is the CMN that has to | | | | GE0 field 6, positions 32 - 33, is the therapy |
| be sent to the carrier with each enteral bill that is | | | | duration. This is the number of months that the |
| submitted for payment via electronic means using | | | | patient is expected to be on enteral nutrition. |
| NSF 3.01 specifications. | | | | Unlike other procedures that are done and |
| GE0 field 1, positions 1 - 3, is the record type. This | | | | completed, enteral nutrition is not so easy to |
| field needs to be filled in with GE0. If it is not, the | | | | pinpoint down to a time since it is impossible to |
| claim will be denied by the carrier. Also, this record | | | | say how long it will be until the patient is able to |
| must come after the F record in the claim file | | | | go without it. That's why this is an estimate. If |
| that is specifically for the enteral product being | | | | the physician believes this will be for the life of |
| billed. | | | | the patient then they fill this field with the number |
| GE0 field 2, positions 4 - 5, is the sequence | | | | 99. |
| number. Because there can be up to 99 CMN | | | | GE0 field 7, positions 34 - 41, is the last date of |
| records in a claim file, the sequence number, or | | | | certification. This is the last date that this |
| CMN number must be transmitted, such as | | | | particular treatment was certified and must be |
| GE0-01, GE0-02, etc. If these are out of | | | | filled in if required by the payer. The format is |
| sequence, the claim will be denied. | | | | either yyyymmdd or mmddyyyy, depending on |
| GE0 field 3, positions 6 - 22, is the patient ID | | | | the payer requirements. |
| number. This is the same number that is | | | | GE0 field 8, positions 42 - 43, is the number of |
| transmitted in the CA0 record and all subsequent | | | | months of this certification. Most CMNs are good |
| records. If this field is not filled in, the claim will be | | | | for a year. However, some initials are good for |
| denied. | | | | only 3 months. This is going to vary from payer |
| GE0 field 4, position 23, is the certification type. | | | | to payer and from item to item. |
| This field is transmitted as either I, for initial or R | | | | In our next installment of medical billing via |
| for recertification. The carrier needs to know this | | | | electronic media, using NSF 3.01 specifications, |
| because billing for each cert type is different. | | | | we're going to continue with our review of the |
| GE0 field 5, positions 24 - 31, is the date therapy | | | | GE0 record, picking up with field number 9. |