Change Request Detail
No.
1034
Date
12/18/2005
Submitter
Type of Request
Institutional Claim (UB-92)
Status
DSMO Process Completed
Business Reason
As proposed for use in Claims Attachments transactions, LOINC values for identifying attachments are more expressive than report type codes currently used in PWK01.  LOINC should be evaluated as a replacement or supplement for the codes presently used, and where found suitable, the use of LOINC in claims transactions synchronized with the adoption of Claims Attachments transactions under HIPAA.
Suggestion
Either  (a) remove the present list of code values allowed in PWK01 and replace with an external reference to LOINC,  (b) one-by-one replace, and even expand, the present list of code values allowed in PWK01 with equivalent LOINC values,  (c) provide an ancillary cross-walk chart between the present list of values allowed in PWK01 with their equivalent LOINC values,  or  (d) provide a detailed explanation of how the present list of values allowed in PWK01 may be mapped to apporopriate LOINC values.   [Note, the author of this change request is well aware that underlying changes to the 837 transaction itself as well as the standard PWK segment will be required to implement some of the listed alternatives due to the field length limitations of PWK01.  The author also believes that one or more alternatives may be implemented faster on an interim basis while another alternative is implemented over a longer time span to achieve the desired full synchronization with the Claims Attachment transaction.]
DSMO Category
D
Recommendation
No change at this point as further analysis is requested. The DSMO recommend that further exploration of the issue be done, and then when appropriate, a technical solution be brought forward as a specific DSMO Change Request. The submitter is requested to participate in ASC X12N WG2 Health Care Claims and Encounters. Co-chairs are Deborah Meisner, emdeon, Dmeisner@emdeon.com, Conny Nichols, Claredi Corporation, Conny.Nichols@claredi.com, Douglas Renshaw, Highmark, Inc., doug.renshaw@highmark.com.
Appeal Recommendation