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Advice You - Medical Billing - GX0 Record Fields 28 Through 37
There is a big misconception about medical billing and the people who do the billing. The layman thinks that these people have no special skills
According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product
and are just your everyday run of the mill office person. This couldn't be further from the truth. A medical biller needs to be extremely shar
; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.
Examples of combination products may in
Examples of combination products may in
p with all the rules and regulations attached to medical billing. And when it comes to billing oxygen claims, it is even more critical that the
lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.
iller be on the top of his game. In this installment on medical billing and the electronic transmission of claims using NSF 3.01 specifications,
here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe
we're going to continue with our review of one of the most complex CMNs in medical billing, the oxygen CMN, or GX0 record. We pick up our revie
d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.
Combination pro
Combination pro
w with field number 28.
GX0 field 28, positions 263 - 265, is the portable oxygen flow rate. This field only applies to a patient who has been
GX0 field 28, positions 263 - 265, is the portable oxygen flow rate. This field only applies to a patient who has been
ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc
iven a portable oxygen device. This field tells the carrier what the oxygen flow rate is, in liters per minute, for a portable oxygen system. I
easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi
f this is entered, the therapeutic purpose of this device must be explained if the patient cannot get the same benefit from a non portable system
nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically
. This must be entered in the GX1 record in field number 6.
GX0 field 29, positions 266 - 280, is the ordering physician ID. This is the ID nu
GX0 field 29, positions 266 - 280, is the ordering physician ID. This is the ID nu
and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ
ber of the physician who ordered the patient to be put on oxygen.
GX0 field 30, positions 281 - 290, is the ordering provider phone number. Thi
GX0 field 30, positions 281 - 290, is the ordering provider phone number. Thi
ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi
s tells the carrier the phone number of the physician who prescribed the oxygen. This is required so that the carrier can call the physician in
ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.
Following aspects would a
Following aspects would a
case there are any questions about this claim. Unfortunately, because of all the red tape with oxygen claims, there usually are questions.
GX0
GX0
dd to the challenges in developing combination products:
Which markets to tap where the combination products can do fairly well?
Which combination prod
Which markets to tap where the combination products can do fairly well?
Which combination prod
ields 31 - 34, positions 291 - 310, are the four diagnosis codes. These are the diagnosis codes related to what the patient needs oxygen and not
cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin
to any procedures that were done to the patient for this claim. Those codes are included in the FA0 record. Currently, these are ICD-9 codes.
tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen
What would be the developing cost?
How to tackle the risks encountered during combination product developmen
ICD-10 codes are out but not yet used for this CMN.
GX0 field 35, position 311, is the certification on file indicator. This field tells the c
GX0 field 35, position 311, is the certification on file indicator. This field tells the c
t?
As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel
As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel
rrier that the actual paper CMN is on file with the doctor and signed by all parties. This does not have to be done at the sending of the claim.
ping new procedures for reviewing their safety, efficacy and quality.
Professional from academic institutions, pharmaceutical industries, health care indust
Professional from academic institutions, pharmaceutical industries, health care indust
but eventually there better be a CMN on file. The valid responses are Y or N.
GX0 field 36, position 312, is the delivery system type. This
GX0 field 36, position 312, is the delivery system type. This
y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products
is a one character code that tells the carrier what type of delivery system the patient has for getting the oxygen. Valid responses are A for na
.
As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de
As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de
al canula, B for O2 conserving device, C for O2 conserving device with pulse O2 system, D for O2 conserving device with reservoir system and E fo
elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.
Companies that provide selfless information through particip
Companies that provide selfless information through particip
r a catheter.
GX0 field 37, positions 313 - 320, is filler national and must be filled with spaces.
This concludes our review of the GX0 record
GX0 field 37, positions 313 - 320, is filler national and must be filled with spaces.
This concludes our review of the GX0 record
tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products
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