Under what circumstances are line item trailers for non-physician specialties excluded?
Records are excluded if any of the following conditions are met: • If the Line Item has been denied (see FAQ 78 for this definition). • If the Line HCPCS Code is ‘G0008’ (Administration of Influenza Virus Vaccine) or ‘90724’ (Influenza Virus Vaccine). These codes are eliminated due to the skewing of the statistics when they are present in the data, primarily in Public Health/Welfare Agencies. • If the Line NCH BETOS code is between ‘D1A’ and ‘D1F’. This is to eliminate Durable Medical Equipment from the analysis. • If Line HCFA Type of Service Code contains a value of ‘8’ (Assistant Surgeon). Applies for Surgical HCPCS only. This condition should not occur for Non-Physician services. • If Line HCFA Type of Service contains a value of ‘F’ (ASC Facility Charge). This is the charge of the Ambulatory Surgical Center (ASC) as the place of service. Note: Items (2) and (3) above are rules that may or may not be appropriate for other applications using Part B data. If counting services by HCPC
Related Questions
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