Top Management Story

Writen by Michael Russell

The long and winding road of medical billing and the GD0 record is starting to see light at the end of the tunnel. If you've been with us this far, hang in there just a little longer. We're picking up our review of this generic CMN with field number 41.

GD0 fields 41 - 44, positions 160 - 179, are the diagnosis codes. Many people don't understand why diagnosis codes are required for a CMN since these codes are transmitted in the FA0 record. Well, the reason that diagnosis codes have to be transmitted with the GD0 record is because these diagnosis codes are specifically for the CMN itself. To understand this, a brief example is required.

Let's say a patient is billing a carrier for a procedure involving surgery for a broken leg. The diagnosis codes for the surgery will be specific for the surgery itself. Now, let's say that same patient because of the surgery can no longer walk and needs a wheelchair. When the CMN is transmitted, the diagnosis codes that go with the CMN are not the ones pertaining to the surgery but are the ones pertaining to the reason why the patient needs a wheelchair.

GD0 field 45, position 180, is the nursing home indicator. This indicator tells the carrier if the patient is currently residing in a nursing home. If so, the field is filled in with a Y. If not, it is filled in with an N.

GD0 fields 46 - 47, positions 181 - 196, are the nursing home from and to dates. These are the dates that the patient resided in a nursing home if the indicator in field 45 is transmitted as a Y. If the patient is still in the nursing home at the time of this transmission and is not expected to be discharged, then the field is left blank.

GD0 field 48, position 197, is the respiratory tract indicator. This field tells the carrier if the patient has mobilizing respiratory tract secretions. If so, this field is transmitted with a Y. If not, this field is transmitted with an N.

GD0 field 49, position 198, is the equipment supervision indicator. This field tells the carrier if the patient is using the equipment that the CMN is for with or without supervision. If with supervision, the field is transmitted with a Y. If without supervision, the field is transmitted with an N. This field is very important because with certain equipment and under certain conditions, if the patient is not supervised and something should happen directly related to the operation of the equipment, there is a good possibility that the accident will not be covered by insurance.

GD0 field 50, position 199, is the propel/lift wheelchair indicator. This tells the carrier if the patient is unable to propel or lift a standard wheelchair. This needs to be sent for patients who are given motorized wheelchairs, which is typically what these CMNs are for. A Y entry means the patient is not able to operate a standard wheelchair.

In our next installment of medical billing, we'll continue our review of the GD0 record with field number 51.