UHIN Required Unknown Values Standard is compatible with all HIPAA requirements.
Purpose: This UHIN Standard is intended to provide guidance for the use of common data values that can be used within the HIPAA transactions when a required data element is not known by the provider, payer or sponsor for patients, enrollees, as well as all other people associated with these transactions. These data values should only be used when the data is truly not available or known. These values are not to be used to replace known data.
Applicability: This UHIN Standard applies to all HIPAA transactions as well as transactions that have been approved by the Utah Health Information Network Board of Directors for implementation.
Basic Concepts:
The required data elements that have been identified for unknown values are:
ELEMENT |
VALUE TO USE |
Service Date |
|
Eligibility Requests (270) |
Use the current days date |
Paper claims |
Payers determine what to use |
Adjudication Date |
|
Remittance Advice (835) |
January 01, 1901 |
Claim Status (276) |
|
Other Claim Dates (See Appendix A) |
January 01, 1901 |
Subscriber Birth Date Patient Birth Date |
January 01, 1901 |
Tax Id |
Send the Tax ID qualifier[1] with Tax ID number of 999999999. |
Street address |
UNKNOWN
|
City |
|
Other Payer ID in 837 |
|
Individual Names |
Detail:
Implementation:
- Every reasonable effort to obtain the actual data value should be attempted before these values are put into the transaction.
- UHIN recommends that UHIN members begin using and accepting these values in production for all HIPAA and UHIN approved transactions.
Implementation Date:
History: (MM/DD/YY)
|
Original |
V3 |
A 1 |
A 2 |
|
ORIGINATION DATE |
08/07/03 |
09/23/10 |
|
|
|
APPROVAL DATE |
5/12/04 |
02/02/2011 |
|
|
|
EFFECTIVE DATE |
6/12/04 |
03/02/2011 |
|
|
|
* A = Amendment
APPENDIX A
OTHER CLAIM DATES
CLAIM LEVEL DATES
Initial Treatment
Onset of Current Illness/Symptom
Acute Manifestation
Accident
Last Menstrual Period
Last X-ray
Hearing and Vision Prescription Date
Disability Begin
Disability End
Last Worked
Authorized Return to Work
Admission
Discharge
Assumed and Relinquished Care Dates
Appliance Placement
Repricer Received Date
Last Seen Date
Property and Casualty Date First Contact
Statement
LINE LEVEL DATES
Certification Revision Date
Begin Therapy Date
Last Certification Date
Test
Shipped
Onset of Current Symptom/Illness
Last X-ray
Initial Treatment
Appliance Placement
Last Seen Date
Prescription Date
Prior Placement
Replacement
Treatment Start
Treatment Completion
[1] If in any of the TR3’s a loop is used where the segment is required, the Tax ID element is required (situational or otherwise), and the data is unknown, then use the recommended value.
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