For the field 2000E-CR607 (Medicare Coverage Indicator) has the following semantic
"SEMANTIC: CR607 indicates if the patient is covered by Medicare. A “Y” value
indicates the patient is covered by Medicare; an “N” value indicates patient is not
covered by Medicare."
It is shown as a REQUIRED field, and the only valid value shown is
W = Not Applicable.
Please resolve the conflict between these two statements.
There is no conflict. Since CR607 is mandatory in the ASC X12 standard, it must be populated. The semantic note identifies the meaning of values "Y" and "N" but states nothing about the value "W", which is a valid code for this data element within the ASC X12 standard. Medicare coverage is not applicable within the scope of the Health Care Services Review Information - Review related to home health care, private duty nursing, or services by a nurse's agency. Therefore, code "W" is required to be sent to meet the standard requirement to populate this element.