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Advice You - Medical Billing - EA0 Record Fields 39 Through 55
If it seems we've been covering the EA0 record for medical billing of claims for a while now, that's because this record has more info than almo
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
st all the other records in the file. We pick up with EA0 record field number 39 in this installment.
EA0 field 39, positions 209 - 241, is th
EA0 field 39, positions 209 - 241, is th
; 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
lab/facility name. This is the legal name of the facility or lab where any work was done. This is a mandatory field and must be filled in or
lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.
he claim will be denied.
EA0 field 40, position 242, is the documentation indicator. There are a number of fields in electronic medical billin
EA0 field 40, position 242, is the documentation indicator. There are a number of fields in electronic medical billin
here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe
that indicate that something is signed or on file. This particular field indicates that whatever documentation is needed to back up this claim
d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.
Combination pro
Combination pro
is indeed on file. This is for legal purposes.
EA0 field 41, position 243, is the documentation type. This is a code that signifies what type
EA0 field 41, position 243, is the documentation type. This is a code that signifies what type
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
of documentation is on file, be it a CMN or a PPG or whatever. This tells the payer what the documentation is.
EA0 field 42, positions 244 - 2
EA0 field 42, positions 244 - 2
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
5, is the function status code. This code relates to the diagnosis of the patient and the status of same. Consult your manual for a more detai
nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically
ed explanation.
EA0 field 43, positions 246 - 247, is the CHAMPUS special program indicator. This is an indicator that tells the payer if this
EA0 field 43, positions 246 - 247, is the CHAMPUS special program indicator. This is an indicator that tells the payer if this
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
is a claim that has to do with a special program in CHAMPUS. CHAMPUS itself was explained in detail in an earlier article. Please consult prev
ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi
ous DA1 record articles for this explanation.
EA0 field 44, position 248, is the CHAMPUS non-availability indicator. This indicator tells the
EA0 field 44, position 248, is the CHAMPUS non-availability indicator. This indicator tells the
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
payer that the claim is not allowed to receive CHAMPUS benefits.
EA0 field 45, position 249, is the supervising provider indicator. This tells
EA0 field 45, position 249, is the supervising provider indicator. This tells
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
the payer that the services rendered were overseen by a supervising provider in addition to the regular physician.
EA0 field 46, positions 250
EA0 field 46, positions 250
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
251, is the resubmission number. This is the number of times that the claim itself has been resubmitted, if indeed that is the case. If this
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
s the initial submission, then this field is left blank.
EA0 field 47, positions 252 - 266, is the resubmission reference number. This is an a
EA0 field 47, positions 252 - 266, is the resubmission reference number. This is an a
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
signed number given to each resubmission.
EA0 field 48, positions 267 - 274, is the date last seen. This is the date that the patient last saw
EA0 field 48, positions 267 - 274, is the date last seen. This is the date that the patient last saw
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
the physician.
EA0 field 49, positions 275 - 282, is the date documentation sent. This is the date that the actual physical documentation for
EA0 field 49, positions 275 - 282, is the date documentation sent. This is the date that the actual physical documentation for
y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products
he claim was sent to the payer.
EA0 field 50, position 283, is the homebound indicator. This tells the payer if the patient is confined to the
EA0 field 50, position 283, is the homebound indicator. This tells the payer if the patient is confined to the
.
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
home.
EA0 fields 51 - 54 are not supported at this time so will not be covered.
EA0 field 55, positions 311 - 320, is filler national and must
EA0 fields 51 - 54 are not supported at this time so will not be covered.
EA0 field 55, positions 311 - 320, is filler national and must
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
be left blank.
This concludes our very long review of the EA0 record. In our next installment, we'll cover more claim data with the EA1 record
This concludes our very long review of the EA0 record. In our next installment, we'll cover more claim data with the EA1 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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