Please identify if the examples below are prohibited in 005010X279 based on the MSG usage requirements identified in 1.4.12 and Note 2 on the 2110C/D MSG segments. The note reads: 2. Under no circumstances can an information source use the MSG segment to relay information that can be sent using codified information in existing data elements (....) The examples in question are:
1. ALL PET SCANS, CAT SCANS, MRI’S WILL REQUIRE A RADIOLOGY QUALITY INITIATIVE #. To OBTAIN YOUR RADIOLOGY QUALITY INITIATIVE #, call X @ #.
2. EB*B*IND*98***23*35*****Y~MSG*Specialist~
Do these MSG examples violate the MSG requirement stated in 005010X279 1.4.12 & Note 2 on the MSG segment? The notes/instructions state that if the information can be codified with existing data elements or segment, the MSG segment must not be used. Each of these examples can be coded using external code lists (Procedure & Taxonomy Codes). Does the MSG requirement apply to external code lists?
Srvc Type Code 62 exists to represent MRI/CT Scan. This code must be used rather than sending the MSG segment. MSG segments must not be used to identify phone numbers and other contact information. Other items in this example that can be codified through external code lists would fall into this category as prohibited as well if the external code list is sufficient to identify the information specifically. For example, if there was a specific CPT code for MRA or PET Scans, that CPT code must be used rather than the placing the CPT code as text in the MSG segment. If more CPT codes are needed than is available to return in a single EB segment, multiple EB segments should be sent. While there is a taxonomy code available for “specialist”, it may only be used if a specific provider is being identified in 2120C/D. If “specialist” is a generic characteristic that applies to the 2110C/D data content, the use of the MSG segment is allowed as it is the only possible way to identify “specialist” in this context.
Separate EBs can be returned for each individual CPT code, or, a range may be sent using EB13-2 for the beginning of the range and EB13-8 for the end of the range if the Information Source chooses to use this range functionality.