Subscriber Client Number: 91234567C Subscriber Assignment of Benefits: Yes Subscriber Release of Information: Yes, Provider Has Signed Statement Permitting Release Coordination of Benefits: Yes Subscriber Social Security Number: entered in Step # 22 Subscriber Gender: <Subscriber Gender codes should return from U to F respectively for three clients> Guarantor Name: Medi-Cal Guarantor Order: 1 Clients Relationship To Subscriber: Self Testing Feature: Modified ICD 10 Codes Step # 24: a new client using 2017-01-01 as the Admission Date. Then make 78 create diagnosis calls with the new ICD10 codes found in Index 1.3. for the client just created to verify the new ICD10 codes are accepted. Operation: CreateClientDiagnosis Data Attribute Values to be entered by the LE Client ID: the Client ID returned in your AdmitNewClient call) Episode ID: 1 Program Of Admission: (Enter the Program of Admission code for Hour Admission’ if you are made ’24 AdmitNewClient call using your ProgramOfAdmission) Date of Diagnosis: 2017-10-01 Type of Diagnosis: Admission Trauma: Unknown General Medical Condition Summary Code: UnknownNotReported Substance / Dependence: No Substance Abuse / Dependence Diagnosis: Do not send Primary Diagnosis: Diagnosing Staff NPI: a practitioner’s NPI from your organization) Diagnosis Billing 1 Diagnosis Status : DiagnosisStatysType Status: Active Diagnosis Ranking: DiagnosisRankingPrimaryType Ranking: Primary ICD10Code: (Enter a code from Index 1.3) Expected Output: (Items in Red Font To Be Completed by the LEs) Acknowledgement: Client Diagnosis web service has been filed successfully. Client ID: DiagnosisUniqueID: DiagnosisRanking: Primary Expected Output: (Items in Red Font To Be Completed by the LEs) DiagnosisStatus: Active ICD10Code: (Code entered in the input) Step # 25: Make 78 update diagnosis calls with the new ICD10 codes found in Index 1.3. for the diagnosis created in Step # 24 to verify the new codes are accepted through Update Diagnosis call.
Subscriber Client Number: 91234567C Subscriber Assignment of Benefits: Yes Subscriber Release of Information: Yes, Provider Has Signed Statement Permitting Release Coordination of Benefits: Yes Subscriber Social Security Number: entered in Step # 22 Subscriber Gender: <Subscriber Gender codes should return from U to F respectively for three clients> Guarantor Name: Medi-Cal Guarantor Order: 1 Clients Relationship To Subscriber: Self Testing Feature: Modified ICD 10 Codes Step # 24: a new client using 2017-01-01 as the Admission Date. Then make 78 create diagnosis calls with the new ICD10 codes found in Index 1.3. for the client just created to verify the new ICD10 codes are accepted. Operation: CreateClientDiagnosis Data Attribute Values to be entered by the LE Client ID: the Client ID returned in your AdmitNewClient call) Episode ID: 1 Program Of Admission: (Enter the Program of Admission code for ’24 Hour Admission’ if you are made AdmitNewClient call using your ProgramOfAdmission) Date of Diagnosis: 2017-10-01 Type of Diagnosis: Admission Trauma: Unknown General Medical Condition Summary Code: UnknownNotReported Substance / Dependence: No Substance Abuse / Dependence Diagnosis: Do not send Primary Diagnosis: Diagnosing Staff NPI: a practitioner’s NPI from your organization) Diagnosis Billing 1 Diagnosis Status : DiagnosisStatysType Status: Active Diagnosis Ranking: DiagnosisRankingPrimaryType Ranking: Primary ICD10Code: (Enter a code from Index 1.3) Expected Output: (Items in Red Font To Be Completed by the LEs) Acknowledgement: Client Diagnosis web service has been filed successfully. Client ID: DiagnosisUniqueID: DiagnosisRanking: Primary Expected Output: (Items in Red Font To Be Completed by the LEs) DiagnosisStatus: Active ICD10Code: (Code entered in the input) Step # 25: Make 78 update diagnosis calls with the new ICD10 codes found in Index 1.3. for the diagnosis created in Step # 24 to verify the new codes are accepted through Update Diagnosis call.
CertificationScript2-ClientServices-v201702.docx