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Technical Questions - Updated October
26,2007
Goal:
To provide a quick reference for commonly asked questions
about the UB-04 837i CHARS system:
CHARS Technical/Vendor
FAQ's
Hospital File Submission Issues from our recent Bulletin:
1. Please send your initial test file with about
10 discharges so it is easier to work with the file
format.
2. Our system cannot process multiple ST – SE
transaction sets within a single file. Each ST – SE set must
have the corresponding header and trailer information and be
submitted as an individual file.
3. File syntax: Some elements must follow 837 file
format syntax or a file will not be able to load into CHARS.
If a “qualifier” code is used in a data segment, the
corresponding data value must also be submitted. If the data
does not exist, the qualifier code should not be included.
For example, if a code designating Primary diagnosis is
included, the associated diagnosis code must follow or the
file will be rejected.
Incorrect syntax for Primary Diagnosis
NTE*ADD*B1R1E2~
HI*BK~ The
qualifier BK is used but there is no diagnosis code
Correct syntax for Primary Diagnosis WITH data value
NTE*ADD*B1R1E2~
HI*BK:193~ The qualifier and data value are used
Correct syntax WITHOUT data value
NTE*ADD*B1R1E2~
HI*BK~
The segment is not used because there is no data value
4. We are using a new secure File Transfer
Mechanism for test files instead of loading through CHARS
UB-92. Please contact Kim Dunlap at 360-236-4208 or
kim.dunlap@doh.wa.gov when you are ready to send a test file.
The staff at DOH is here to assist hospitals as they bring
their files through the testing process. Please let Kim know
if you need to be connected with our technical staff to
resolve issues.
5. Files submitted through the web interface
cannot contain an underscore in the name of the file. For
example, a file name like “Hospital_200707” will not process.
Other than this, all Microsoft file naming conventions are
available.
6. DOH Hospital License numbers are listed in
Appendix F of the CHARS Procedure Manual for UB-04. The
CHARS Procedure Manual and Companion Guide is located at
http://www.doh.wa.gov/EHSPHL/hospdata/CHARS_UB04/
Questions:
CHARS Technical/Vendor
FAQ's
T1
Will DOH be using the new information regarding patient
relationship to subscriber and subscriber information?
T2. Does the COMPANION GUIDE reflect “required” fields?
Can we skip anything not listed here?
T3 Can we skip anything not listed in the COMPANION
GUIDE? If the X12-8371 guide says a field is
required, but it is not listed in the CHARS list—is it
required or optional?
T4 My assumption on most of these is “Follow the ANSI
spec” –but then we’d still need a list of which
fields/segments are “required” and which can be skipped.
T5 What types of patient discharges do we report to CHARS in
the UB-04 format?
T6
Can hospitals skip anything not
listed in the Companion Guide, such as Condition Codes,
Occurrence Codes, Span Codes?
Technical/Vendor FAQ's
T1 Will DOH be using the new information regarding
patient relationship to subscriber and subscriber information?
Yes. The data is required for file processing.
T2. Does the COMPANION GUIDE reflect “required” fields?
Can we skip anything not listed here?
Yes, Yes.
T3 Can we skip anything not listed in the COMPANION
GUIDE? If the X12-8371 guide says a field is
required, but it is not listed in the CHARS list—is it
required or optional?
If the x12-8371 guide says a field is required, it is
required. Many, though not all, of the fields not mentioned
amplify the required elements or are to process a claim.
The intent of the COMPANION GUIDE is to supplement, not
replace the X12 spec. It highlights the data elements
that we will collect and provides the field values that are
state-specific which may differ from X12 for
reimbursement by payer
Comment: For the electronic UB V5, only the listed
fields were required, all other fields were optional or not
sent. This CHARS and future versions will stay as close
as practical to national standards, especially to the UB and
the X12 to be compatible with a range of billing
software to make the file with a minimum of changes .
T4 My assumption on most of these is “Follow the ANSI
spec” –but then we’d still need a list of which
fields/segments are “required” and which can be skipped
.
You are correct, follow the ANSI spec.
T5 What types of patient discharges do we report to CHARS in
the UB-04 format?
Hospitals should report inpatient discharges AND
OBSERVATION STAYS. PER WAC 246-455-010 Definitions (8)
“patient discharge means the termination of an inpatient
admission or observation stay, including admissions as a
result of a birth, in a Washington Hospital.”
T6 Can hospitals skip anything not listed in the Companion
Guide, such as Condition Codes, Occurrence Codes, Span Codes?
Hospitals can skip anything unless it is
required for X12 syntax!
Specialized Topic Page
CHARS Hospital
Representative and Technical Information Page
This page is for data provider hospitals to stay informed on
their role.
Frequently
Asked Questions - FAQ's
This page is for answers to common questions about our new
UB-04 CHARS
Washington Administrative Code
(WAC) Change Process
This page will track the process to update the CHARS WAC.
Recommendation
Committee
The committee purpose was to review additional elements to
collect for the CHARS system.
Contact Information:
email:
Chars UB-04 Process
Comments or questions regarding this process or this web site?
Send email to Hospital
Data at CHS
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