Medical Billing - GX0 Record Fields 24 Through 27

Medical billing of oxygen claims is not for the mentally challenged. Medical billers should really be paid a lot more money than they are, but that is not the focus of this article. Our focus is to try to make heads or tails out of one of the most complex records in the medical billing industry, which is the GX0 record. In this segment, we resume our discussion of this record with field number 24.

GX0 field 24, positions 218 - 225, is the date tests performed. Honestly, this is a very poorly worded field. What tests? Well, you'll have to read the manual to figure this out, but in brief, this is the date that the arterial blood gas and oxygen saturation tests were performed. Under normal conditions, these tests are performed at the same time. But things happen. In the case where you have two different dates, consult with your carrier to find out which date to use. Trust me, it will happen. The date itself can be transmitted in either yyyymmdd or mmddyyyy format, depending on the requirements of the carrier. Again, check your manual.

GX0 field 25, positions 226 - 258, is the entity performing the oximetry testing. This field tells the carrier the name of the entity who performed the ABG and/or oximetry tests. To properly fill out this field, please see the general instructions in your manual for "NAME 2" entry.

GX0 field 26, position 259, is the test conditions field. This is another one of those fields where the name doesn't tell us much of anything. This field tells the carrier the condition of the patient when the tests were given. The valid responses are 1 for at rest, 2 for exercising and 3 for sleeping. This is a required field and cannot be left blank.

GX0 field 27, positions 260 - 262, is the clinical findings field. This field tells the carrier if certain conditions existed when doing the tests. These are as follows:

If the patient's arterial PO2 is over 55 mm Hg and under 60 mm Hg.

If the patient's oxygen saturation is over 88%.

If either of these is true then the field is transmitted with a Y. If not, then the field is filled with an N. If it doesn't apply then the field is left blank.

Okay, it gets more complicated. As you can see, it is a 3 character field. The reason is because you can have up to three responses. Position 1 is if the patient has dependent edema due to congestive heart failure. Position 2 is if the patient has pulmonary hypertension as shown by either a gated blood pool, or direct pulmonary artery pressure measurement. Position 3 is if the patient has a hemacrit greater than 56 percent. It is therefor possible to have a response such as YYN or YNY or any valid combination of the three possible responses.

In our next installment on medical billing, we'll be continuing with our review of the GX0 record, picking up with field number 28.

Michael Russell Your Independent guide to Medical Billing Article Source: http://EzineArticles.com/?expert=Michael_Russell

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