In our continuing and seemingly endless series on medical billing of claims via electronic means using NSF 3.01 specifications, we'll be picking up with our review of the GD0 record, which is a generic CMN, starting with field number 18.
GD0 field 18, position 61, is the siderails part of bed indicator. This indicator tells the carrier if the bed that the patient owns has siderails attached to it. The key word to this field is owns. The patient must own and not rent the bed, for this to apply. So even if the patient has siderails, if the bed is rented, this field would not be filled with a Y.
GD0 field 19, position 62, is owns equipment indicator. This tells the carrier if the patient owns any hospital equipment at all, whether it be a bed, wheelchair or any other item. If the patient does own equipment, this field is filled with a Y. If not, it is filled with an N. Again, renting and owning are not the same thing.
GD0 field 20, position 63, is the mattress/siderails used indicator. This indicator tells the carrier if the bed owned by the patient, has special mattress and or siderails installed because of medical necessity. If so, this field is filled with a Y. If not, it is filled with an N.
GD0 field 21, position 64, is the equipment assistance indicator. This indicator tells the carrier if the patient needs some sort of lift to get from bed to wheelchair or wheelchair to bed. If so, this field is filled with a Y. If not, it is filled with an N.
GD0 field 22, position 65, is the orthopedic impairment indicator. This indicator tells the carrier if the patient has some sort of orthopedic condition that makes it so that they need special equipment to get around. If so, this field is filled with a Y. If not, it is filled with an N.
GD0 field 23, position 66, is the planned regimen indicator. This indicator tells the carrier if the patient has this particular item as part of a planned regimen. This is usually something that relates to therapy after an illness or accident. If this is so, the field is filled with a Y. If not, it is filled with an N.
GD0 field 24, position 67, is the decubitus ulcers indicator. This indicator tells the carrier if the patient is prone to getting these type of ulcers. If the patient is prone, the field is filled with a Y. If not, it is filled with an N.
GD0 field 25, position 68, is the equipment use indicator. This indicator tells the carrier if the patient or the person taking care of the patient has been instructed in the proper use of the item prescribed, whether it be a wheelchair or bed. In many cases, if no instruction is given, the claim will be denied, as most carriers require this instruction in order for the claim to be paid. If the instruction was given, the field is filled with a Y. If not, it is filled with an N.
In our next installment of medical billing, we'll cover the GD0 record starting with field number 26.