Stream: CARIN IG for Blue Button®
Topic: ExplanationOfBenefit.item.revenue
John Achoukian (Sep 24 2020 at 20:59):
C4BB-ExplanationOfBenefit-Outpatient-Institutional
ExplanationOfBenefit.item.revenue
The binding indicates codes SHALL be taken from AHA NUBC Revenue Codes
The reference link to AHA NUBC Revenue Codes (https://build.fhir.org/ig/HL7/carin-bb/ValueSet-AHANUBCRevenueCodes.html) is blank. Please advise.
Saul Kravitz (Sep 25 2020 at 18:12):
Which version are you look at?
Here is the current CI build (v0.1.3:
image.png
The link to AHA NUBC Revenue Codes works for me.
Josh Lamb (Sep 25 2020 at 19:05):
I believe the issue is that we do not provide the actual codes. My understanding is that payers have access to the AHA NUBC Revenue codes so they are not provided within IG (covered by IP?).
Saul Kravitz (Sep 29 2020 at 21:24):
For Codesystems whose name does not begin with C4BB (e.g., AHANUBCRevenueCodes), the codes are provided only to licensed users, and are thus not included in the IG.
John Achoukian (Oct 20 2020 at 23:54):
Hi @josh lamb If revenue and CPT/HCPCS are on separate service lines, how can they be expected to be at the same item level 1..1?
Josh Lamb (Oct 21 2020 at 19:10):
For Institutional claims only, current requirements would need each line to include both Revenue and ProductOrService. Is this an issue in your system? I would reach out to @Pat Taylor @Amol Vyas or @Mark Roberts if additional clarification is needed.
Pat Taylor (Oct 21 2020 at 22:08):
For Inpatient Institutional, there may not be a CPT / HCPCS code. However, the cardinality of the HL7 base EOB Resource for item.productOrService is 1..1 if .item is provided. Since.item.revenue will be provided that means that item.productOrService must be populated. Since the profile is not able to relax the cardinality, the recommendation is to provide a data absent reason in the event a CPT / HCPCS code is not available? @Amol Vyas
Last updated: Apr 12 2022 at 19:14 UTC
