Anesthesia Pain Management, CR 30025

March 8, 2013

Code 01996, Anesthesia Pain Management, was inadvertently set up in MIHMS as minutes-based instead of unit-based. Currently, the HIPAA 837 claims transactions require an MJ (minutes) qualifier in SV104 of the electronic transaction. As a result, these transactions are being rejected when submitted with the UN (unit) qualifier in SV104. The Direct Data Entry (DDE) portal for claims only allows minutes to be entered for this code. Units are then calculated directly from the minutes entered. As a work-around to the unit requirement for this code, providers can submit claims in the following manner for correct processing:

  • HIPAA 837 claims transactions: Submit Code 01996 as one minute using the MJ qualifier in SV104

  • DDE Portal: Submit Code 01996 as one minute; the portal will calculate this as a “0” unit, but will process correctly

  • Paper: Submit Code 01996 as one unit We will inform you when the system can accept the UN qualifier in SV104.

Please note: If you have submitted claims for Code 01996 with 7.5 minutes or greater, your claims have been overpaid. You must submit replacement claims (adjustments) for one minute to correct these overpayments.