| DESCRIPTION |
The data for BOX 19 on the HCFA 1500. This data is derived from a
NO ASSIGNMENT OF BENEFITS (if no assignment of benefits indicated)
Hearing aid testing (if applicable)
DENTAL SURGERY (if applicable)
ATTENDING PHYSICIAN NOT HOSPICE EMPLOYEE (if applicable)
LOW OSMOLAR CONTRAST MATERIAL (if applicable)
SHARED POST-OP CARE TRANSITION DATE (if applicable)
COMMENTS IN BOX 19 DATA FIELD
REMARKS IN BILL COMMENTS
You will need to use the Medicare manual to determine when these data
combination of different data throughout the system and is limited to 80
elements are needed and specifically what data is to be reported. If the
individual data elements cannot be entered into VistA in unique fields,
you will need to enter the corresponding text into the free text box 19
field.
characters. The hierarchy for including data is as follows (until 80
characters have been used):
DATE LAST SEEN and REFERRING PHYSICIAN ID# (physical therapy)
X-RAY DATE (chiropractic)
HOMEBOUND INDICATOR (independent lab renders an EKG or obtains specimen
from a homebound patient)
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