Clients admitted to an inpatient facility can be granted leaves of absence. Some absences are paid by funding sources and others are not. In the case where a patient is granted a paid leave of absence, how would this be documented on the 837I claim? Could you show how a claim with billable versus the non-billable leave should be submitted?
Discussion with TGB/WG2:
I brought this RFI to TGB/WG2 at the Standing Meeting. After much discussion this draft response was suggested:
The version 005010 ASC X12 Institutional Claim TR3, 005010X223, supports the ability to bill leaves of absence through use of National Uniform Billing Committee (NUBC) Revenue Codes; see ASC X12 External Code Source 132. NUBC Revenue Codes are placed in segment SV2; data item SV201. According to the NUBC, the Revenue Code for Leave of Absence is 018x.
If the Leave of Absence, data item SV201 = 0180, is a fully covered charge, the amount of the charge would be placed in data item SV203. If the Leave of Absence is not a fully covered charge, the amount that is covered would be placed in data item SV203, and the amount that is not covered would be placed in data item SV207.
The version 005010 ASC X12 Institutional Claim TR3, 005010X223, supports the ability to bill leaves of absence through the use of National Uniform Billing Committee (NUBC) Revenue Codes; see ASC X12 External Code Source 132. If the Leave of Absence is not covered or not fully covered, the amount that is not covered would be placed in data element SV207.
The total charge for this service would be reported in the SV203.
Recommendation: X12 recommends that billing questions involving the use of the specific Revenue Codes to report Leave of Absence be directed to the NUBC for instructions