Add field to OM1 Segment for Performing Location



V 2.8 HL7 Proposal | |

|Change Request ID: |To be Defined |

|File Name: |DME in FT1 |

|Description: |Add new DME fields and associate a PRT segment |

|Status: |New Proposal |

|Sponsoring Person |Hans Buitendijk |

|Sponsoring Business Unit |Siemens Healthcare |

|Date Originated: |11/18/2011 |

|Date HL7 approved: | |

|Backward Compatible: |Yes |

|Forward Compatible: |Yes |

|HL7 Status & Date | |

Justification Detail:

To improve support for durable medical equipment information on charge transactions we need to expand FT1 to cover these fields. While for most addition of fields would be appropriate, for one field we believe we may want to start to use the PRT segment to enable future additions of similar fields more easily.

Open Issues:

Change Request Impact:

No known impact.

Documentation Changes:

1) Add the following fileds to FT1. We request that the sequence numbers are locked in so we can pre-adopt once the workgroup agrees these are valid additions while the final ballot may still yield adjustments.

HL7 Attribute Table - FT1 - Financial Transaction

|SEQ |LEN |

|AD |Certification Included in this Claim |

|AF |Narrative Segment Included in this Claim |

|AG |No Documentation is Required |

|NS |Not Specified |

1 FT1-45 DME Certification Type (CWE) nnnnn

Definition: This code identifies the type of certification for the durable medical equipment service.

For the US realm, the ANSI ASC X12 CR3 Durable Medical Equipment Certification Segment, reference element CR301, listed below is suggested to map to the X12 837 values:

|I |Initial |

|R |Renewal |

|S |Revised |

2 FT1-46 DME Duration (NM) nnnnn

Definition: This is the length of time, in months, the durable medical equipment is needed.

3 FT1-46 DME Certification Revision Date (DT) nnnnn

Definition :This is the durable medical equipment certification revision/recertification date. It is required when the DME Certification Type Code is set to Renewal or Revised.

4 FT1-47 DME Initial Certification Date (DT) nnnnn

Definition : This is durable medical equipment initial certification date. It is used to indicate the beginning of therapy and the DME Certification Type Code is set to Initial.

5 FT1-48 DME Last Certification Date (DT) nnnnn

Definition: This is the durable medical equipment last certification date. This is required if it is necessary to include supporting documentation in an electronic form for Medicare DMERC claims for which the provider is required to obtain a Certificate of Medical Necessity (CMN) from the physician.

6 FT1-48 DME Length of Medical Necessity Days (NM) nnnnn

Definition : This is the length of duration, in days, of medical necessity for the purchased or rental durable medical equipment service.

7 FT1-49 DME Rental Price (MO) nnnnn

Definition: This is the rental price of the durable medical equipment.

8 FT1-50 DME Purchase Price (MO) nnnnn

Definition: This is the purchase price for the durable medical equipment.

9 FT1-51 DME Frequency (CWE) nnnnn

Definition: This is the frequency or type of payment for the rental of durable medical equipment.

For the US realm, the ANSI ASC X12 SV5 Durable Medical Equipment Service Segment, reference element SV506, listed below is suggested to map to the X12 837 values:

|1 |Weekly |

|4 |Monthly |

|6 |Daily |

10 FT1-52 DME Certification Condition Indicator (ID) nnnnn

Definition: This field indicates if the DME Condition Codes apply to the service. Refer to HL7 Table 0136 - Yes/no Indicator for valid values. A "Y" value indicates the condition codes apply. An "N" value indicates the condition codes do not apply.

11 FT1-53 DME Condition Indicator (CWE) nnnnn

Definition: This the condition indicator code for durable medical equipment. It is used on the claim service line when this information is necessary for adjudication. Two occurrences are supported.

For the US realm, the ANSI ASC X12 CRC DMERC Condition Indicator Segment, reference element CRC03, listed below is suggested to map to the X12 837 values:

|38 |Certification signed by the physician is on file at the |

| |supplier’s office |

|ZV |Replacement Item |

2) Add the PRT segment to every FT1 with support participation codes.

• Wherever FT1 is referenced (across all messages) replace FT1

o Old: FT1

o New: FT1 [{PRT}]

• Add to Table 0912 Participation the following codes:

o Exempted Investigational Device

• Consider deprecating the following fields and add the appropriate participation to Table 0912:

o FT1.13

o FT1.16

o FT1.20

o FT1.21

o FT1.24

o FT1.32

o FT1.33

o FT1.35

o FT1.37

o FT1.40

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