National Uniform Claim Committee (NUCC)
Conference Call on April 10, 2014
Summary by: Barbara Rudolph, NAHDO Consultant
Following approval of the minutes from the February meeting, the committee discussed three topics: an update on the transition of the 1500 paper claim; the change request for the unique device identifier (UDI), and the impact of the ICD-10 delay on the 1500 Transition. There was a quorum present on the call (for a list of members go to: http://www.nucc.org/index.php?option=com_contact&view=category&id=4&Itemid=107 ).
I. Update on 02/12 1500 Transition
The Committee discussed the progress on the transition to the revised 1500 paper claim form and determined there was no need to delay the transition to the revised form; the form was approved in June 2013 after extensive public comments. The transition is not being impacted by the ICD-10 delay in implementation. Ms. Meisner reported that she was just on a call with 33 vendors and she heard no issues from them about the form. Ms. Ochal-Thompson stated that she has not heard any issues from vendors either. Ms. Spector stated that some payers are still using the old 1500 form because they are not ready to accept the revised form. The Committee agreed that this is allowable because there is no regulatory mandate to use the revised form. Ms. Sikora stated that Medicare has not seen any issues with the form. The questions they have received have been about interpreting the changes. For a summary of changes and a copy of the form go to: http://www.nucc.org/images/stories/PDF/understanding_the_changes_to_the_0212_1500_claim_form.pdf
II. Unique Device Identifier
Ms. Spector reviewed the Committee’s discussion at the joint in-person meeting in February regarding submitting a letter to relevant entities expressing the NUCC’s concerns about the UDI number being a requirement on the claim form. She stated that there was not a quorum at the meeting and therefore no vote was taken regarding the decision to send a letter. She revived the discussion to get feedback from the Committee about the letter.
Ms. Burckhardt reported that a change request has been submitted to X12 and will be discussed by TGB WG2 Claims. Ms. Kocher explained that X12 would not submit a DSMO request for this, but the change, if included in a version of the TR3 that is brought forward through a DSMO request, would be included there. There was discussion about whether or not a business case has been made to include UDI in the claim. Ms. Burckhardt explained that a business case has been made in the WEDI Foundation white paper, which is an addendum to the change request, but the WG will have to decide if it is sufficient to move the request forward. Mr. Tennant stated that the claim might not be the best approach to capture this information, since a claim might not be submitted for the service. Mr. Arges explained that the white paper gives the pros and cons of various options. For the EHR, it says that the data fields are not present. Mr. Tennant explained that EHR certification will be the vehicle for getting the data fields added. Ms. Ochal stated that adding UDI to the EHR is included in the 2015 voluntary certification NPRM.
Ms. Spector asked if a letter should be drafted by the NUCC regarding the collection of the UDI on a claim form. A quorum (of members) approved the drafting of a letter by Ms. Spector. The letter will be emailed to members for comments, and then a vote of approval would be sought when the draft is final.
III. Impact of ICD-10 Delay on the Transition to the new 1500 form
The Committee discussed the recent delay in the ICD-10 deadline. There was discussion about the ICD indicator on the new 1500 form now that ICD-10 has been delayed. Ms. Kalland stated that BCBSMN is sending back forms on which the indicator is not present. Ms. Sikora reported that Medicare is doing the same thing. Ms. Spector stated that it would be interesting to have some feedback in terms of how the 1500 forms are being submitted specifically around the ICD indicator. Ms. Ochal said that she would check with HIMSS. Ms. Kalland said she would check with AHIP.
Next Meeting is: May 8, 2014