Section title: Requests for Interpretation
RFI #
1042
2300 CRC03 Codes
Description

02' (Patient was bed confined before the ambulance service) and '03' (Patient was bed confined after the ambulance service) were deleted for 5010, and '12' (Patient is confined to a bed or chair) was added for 5010.

If we receive a 4010 claim with a '02' or '03', what should we convert the value to for 5010? Is it safe to use '12'? We were not sure since there is a note under '12' in the guide that states "Use code 12 to indicate patient was bedridden during transport."

RFI Response

This issue is explicitly addressed in guide 005010X222. The CRC03 codes "02" and "03" have been deleted and have no exact equivalents in the guide. The note on code "12" states "Use code 12 to indicate patient was bedridden during transport."

The meaning of code 12 in this context only indicates that the patient is bedridden during transport.

How to map from 004010 to 005010 would be a business decision. Note that in 005010, the 2300 CRC segment is not sent if there are no condition codes to report.

DOCUMENT ID
00501X222