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  • Casual Articles - Medical Billing - GX1 Record

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    d here if out of the ordinary.

    GX1 field 5, positions 113 - 202, is additional medical findings. This is another narrative field where the carrier is told any additional medical findings to justify putting the patient on oxygen. This is required because oxygen use is very regulated and the carrier needs to make absolutely sure that the patient is indeed in need of oxygen therapy. This is especially necessary if the PO2 levels are 60 mm Hg or above or oxygen saturation is above 90 percent. The reason is because in

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    If you thought it was safe to come out of your bunker now that our review of the GX0 record is over, you may want to crawl back in. We're not quite done with our oxygen billing review in regard to medical billing in general. In this installment we begin our review of the narrative record, which is the GX1 record.

    The GX1 record has only 7 fields in it. You would therefore think that there is just no way to screw this record up. And yet, there are more problems with the GX1 record and denials than the GX0 record. The reason for this is because the majority of the fields are not simple one or two character replies. Most of the responses are narrative ones and lengthy at that. When you combine that with the fact that, unfortunately, many billers do not have English as their first language, this causes a number of problems. Proper training in narrative explanation is critical to getting these claims accepted by the carrier.

    GX1 field 1, positions 1 - 3, is the record type. This field tells the carrier what the record is that is being transmitted and needs to be filled with GX1 or the claim will be denied.

    GX1 field 2, positions 4 - 5, is the sequence number. Because there can be as many as 99 narrative records sent with each claim, a sequence number must be transmitted for each GX1 record. These are transmitted as GX1-01, GX1-02 and so on. These cannot be out of sequence or the claim will be denied. Also, the GX1 records must follow the GX0 records.

    GX1 field 3, positions 6 - 22, is the patient control number. This is the same patient ID number that is transmitted in the CA0 record and all subsequent records containing patient information. This number must match the CA0 record or the claim will be denied.

    GX1 field 4, positions 23 - 112, is the test results narrative. This field tells the carrier if the oxygen tests that were performed were done under unusual conditions. This can cover just about anything from where the tests were performed to how they were performed. Also, an explanation of how these tests were interpreted is also required here if out of the ordinary.

    GX1 field 5, positions 113 - 202, is additional medical findings. This is another narrative field where the carrier is told any additional medical findings to justify putting the patient on oxygen. This is required because oxygen use is very regulated and the carrier needs to make absolutely sure that the patient is indeed in need of oxygen therapy. This is especially necessary if the PO2 levels are 60 mm Hg or above or oxygen saturation is above 90 percent. The reason is because in t

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    The reason for this is because the majority of the fields are not simple one or two character replies. Most of the responses are narrative ones and lengthy at that. When you combine that with the fact that, unfortunately, many billers do not have English as their first language, this causes a number of problems. Proper training in narrative explanation is critical to getting these claims accepted by the carrier.

    GX1 field 1, positions 1 - 3, is the record type. This field tells the carrier what the record is that is being transmitted and needs to be filled with GX1 or the claim will be denied.

    GX1 field 2, positions 4 - 5, is the sequence number. Because there can be as many as 99 narrative records sent with each claim, a sequence number must be transmitted for each GX1 record. These are transmitted as GX1-01, GX1-02 and so on. These cannot be out of sequence or the claim will be denied. Also, the GX1 records must follow the GX0 records.

    GX1 field 3, positions 6 - 22, is the patient control number. This is the same patient ID number that is transmitted in the CA0 record and all subsequent records containing patient information. This number must match the CA0 record or the claim will be denied.

    GX1 field 4, positions 23 - 112, is the test results narrative. This field tells the carrier if the oxygen tests that were performed were done under unusual conditions. This can cover just about anything from where the tests were performed to how they were performed. Also, an explanation of how these tests were interpreted is also required here if out of the ordinary.

    GX1 field 5, positions 113 - 202, is additional medical findings. This is another narrative field where the carrier is told any additional medical findings to justify putting the patient on oxygen. This is required because oxygen use is very regulated and the carrier needs to make absolutely sure that the patient is indeed in need of oxygen therapy. This is especially necessary if the PO2 levels are 60 mm Hg or above or oxygen saturation is above 90 percent. The reason is because in

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    s being transmitted and needs to be filled with GX1 or the claim will be denied.

    GX1 field 2, positions 4 - 5, is the sequence number. Because there can be as many as 99 narrative records sent with each claim, a sequence number must be transmitted for each GX1 record. These are transmitted as GX1-01, GX1-02 and so on. These cannot be out of sequence or the claim will be denied. Also, the GX1 records must follow the GX0 records.

    GX1 field 3, positions 6 - 22, is the patient control number. This is the same patient ID number that is transmitted in the CA0 record and all subsequent records containing patient information. This number must match the CA0 record or the claim will be denied.

    GX1 field 4, positions 23 - 112, is the test results narrative. This field tells the carrier if the oxygen tests that were performed were done under unusual conditions. This can cover just about anything from where the tests were performed to how they were performed. Also, an explanation of how these tests were interpreted is also required here if out of the ordinary.

    GX1 field 5, positions 113 - 202, is additional medical findings. This is another narrative field where the carrier is told any additional medical findings to justify putting the patient on oxygen. This is required because oxygen use is very regulated and the carrier needs to make absolutely sure that the patient is indeed in need of oxygen therapy. This is especially necessary if the PO2 levels are 60 mm Hg or above or oxygen saturation is above 90 percent. The reason is because in

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    tient ID number that is transmitted in the CA0 record and all subsequent records containing patient information. This number must match the CA0 record or the claim will be denied.

    GX1 field 4, positions 23 - 112, is the test results narrative. This field tells the carrier if the oxygen tests that were performed were done under unusual conditions. This can cover just about anything from where the tests were performed to how they were performed. Also, an explanation of how these tests were interpreted is also required here if out of the ordinary.

    GX1 field 5, positions 113 - 202, is additional medical findings. This is another narrative field where the carrier is told any additional medical findings to justify putting the patient on oxygen. This is required because oxygen use is very regulated and the carrier needs to make absolutely sure that the patient is indeed in need of oxygen therapy. This is especially necessary if the PO2 levels are 60 mm Hg or above or oxygen saturation is above 90 percent. The reason is because in

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    d here if out of the ordinary.

    GX1 field 5, positions 113 - 202, is additional medical findings. This is another narrative field where the carrier is told any additional medical findings to justify putting the patient on oxygen. This is required because oxygen use is very regulated and the carrier needs to make absolutely sure that the patient is indeed in need of oxygen therapy. This is especially necessary if the PO2 levels are 60 mm Hg or above or oxygen saturation is above 90 percent. The reason is because in these cases, rarely is oxygen needed.

    GX1 field 6, positions 203 - 292, is the exercise routine narrative. This field tells the carrier any exercise that the patient has to do that required him to have a portable oxygen system.

    GX1 field 7, positions 292 - 320, is filler national and must be filled with spaces.

    This concludes our review of the GX1 record for medical billing.

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