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# | Location | File | Last Modified |
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1 | CCRS.zip\CCRS\CCRS-BUSRULES-v1.5.3.zip\CCRS-BUSRULES-v1.5.3-436e6fff1115001d614ccd45b469ad60a9bdb27b\docs | SEOC_Taxonomy.xlsx | Tue Apr 10 06:18:41 2018 UTC |
2 | CCRS.zip\CCRS\CCRS-BUSRULES-v1.5.3.zip\CCRS-BUSRULES-v1.5.3-436e6fff1115001d614ccd45b469ad60a9bdb27b\docs | SEOC_Taxonomy.xlsx | Fri Jun 15 15:22:35 2018 UTC |
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1 | SHEET: She et1 | |
2 | Attribute, Data Type, Data Defin ition,Exam ple, | |
3 | SEOC ID Nu mber,Strin g,Service Line Abbre viation_SE OC Name_Ve rsion Numb er_PAL (if a PAL SEO C)_PCRT (i f need pre -cert),PMR _CHIROPRAC TIC_1.0.1, | |
4 | Service Li ne (associ ated with the specia lty),Strin g,Service Line for e ach SEOC,R ehabilitat ive Servic es, | |
5 | Category o f Care (CO C),String, Category o f Care ass ociated wi th SEOC,Ch iropractic , | |
6 | SEOC Name ,String,Na me of the SEOC,Chiro practic, | |
7 | Clinical S ervice,Str ing,The cl inical ser vice assoc iated with the SEOC, N/A, | |
8 | Continued Pain Manag ement, | |
9 | Version,St ring,Versi on number if the SEO C,1.0.1, | |
10 | Version Ef fective St art Date,D ate,The ef fective st art date f or this ve rsion of t he SEOC,1- Jan-18, | |
11 | [Month/Day /Year], | |
12 | Version Ef fective En d Date,Dat e,The effe ctive end date for t his versio n of the S EOC,1-Jun- 18, | |
13 | [Month/Day /Year], | |
14 | No. of Ser vice/,Numb er,The num ber of ser vices asso ciated wit h the SEOC ,1, | |
15 | Procedure within SEO C,2, | |
16 | 3, | |
17 | Service/Ca re Request ed,String, One or mor e services associate d with the SEOC,Brea st MRI inc luding CHE M panel, a s clinical ly indicat ed, | |
18 | Duration,N umber,The window of time appro ved to pro vide this service,90 , | |
19 | (days), | |
20 | Authorized No. of V isit(s) - by Service ,Number,Th e numerica l amount o f approved visits fo r a partic ular servi ce,4, | |
21 | CPT Codes, Number,The CPT code set descri bes medica l, surgica l, and dia gnostic se rvices and is design ed to comm unicate un iform info rmation ab out medica l services and proce dures amon g physicia ns, coders , patients , accredit ation orga nizations, and payer s for admi nistrative , financia l, and ana lytical pu rposes. ,9 9201, | |
22 | CPT Descri ption,Stri ng,Provide s a short, plain lan guage desc ription of the servi ce/procedu re each in dividual C PT code re presents,O ffice or o ther outpa tient visi t for the evaluation and manag ement of a n establis hed patien t, | |
23 | Disclaimer ,String,Co mmunity pr ovider nee ds to see this as it identifie s certain details ex clusive to VA that t hey would not encoun ter with a ny other i nsurer,** All reques ts for add itional th erapeutic modalities , includin g heat/col d modaliti es and mas sage thera py, | |
24 | require V A review., | |
25 | Pre-Cert s ervices,Nu mber,Ident ifies indi vidual CPT codes tha t require insurance pre-certif ication fo r Veterans who have Other Heal th Insuran ce.,77077, 20526, 20 527, 23020 , | |
26 | PAL SEOC,B oolean,A y es/no indi cator that defines t he SEOC is a service listed on the Prior Authoriza tion List (PAL),Yes , | |
27 | DRG,String ,An inpati ent code f or the Dia gnostic Re lated Grou p (DRG) th at defines the cost, complexit y and leng th of stay for inpat ient servi ces,D12.56 , | |
28 | QASP categ ory,String ,Is a sing le selecti on at the SEOC level of five c ategories under the Quality As surance Su rveillance Plan (QAS P). Those categories are: Gene ral Care, Primary Ca re, Genera l Dentistr y, Special ty Dentist ry, Compli mentary & Integrativ e Health C are,Genera l Care , |
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