Chapter IV: Inquiries Submenu (01)
Opioid Use Disorder (OUD) Demo 99 (1F)
Purpose
The purpose of the OUD DEMO option is to provide claim information such as CAP (maximum number of claims that can be billed by the provider with HCPCS G2172), amount paid and number of units each OUD HCPCS code is billed by individual OUD providers for Demo 99 claims.
To access the OUD DEMO option from the FISS online system INQUIRES submenu, type ‘1F’ at the Enter Menu Selection: prompt, then press <Enter>.
Upon selecting the OUD DEMO 99 option, the Opioid Use Disorder DEMO 99 Inquiry screen is available:
To access Opioid Use Disorder data, enter your facility’s OSCAR number in the CCN field and NPI number in the NPI field, then press <Enter>.
The Opioid Use Disorder DEMO 99 Inquiry screen will refresh to display the following information:
| Field | Description |
|---|---|
| EFF DATE | Identifies the Effective date for the Provider CCN/NPI combination entered (eight-position numeric field in MM/DD/YY format) |
| TERM DATE | Identifies the Termination date for the Provider CCN/NPI combination entered (eight-position numeric field in MM/DD/YY format) |
| PROVIDER TYPE | Identifies the Provider specialty (one-position numeric field) Valid values 1 = Physician 2 = Group Practice 3 = Hospital Outpatient Department 4 = Federally Qualified Health Center 5 = Rural Health Clinic 6 = Community Mental Health Center 7 = Certified Community Behavioral Health Clinic 8 = Opioid Treatment Program 9 = Critical Access Hospital |
| CAP YEAR | Identifies the CAP year for the provider (four-position numeric field in YYYY format) Note: CAP represents the number of claims reporting HCPCS code G2172 that the provider can submit between the Effective date and Termination date for CAP year (based on CCN/NPI combination) |
| CAP LIMIT USED | Identifies the number of claims out of the CAP limit that have been billed by the provider (five-position numeric field) |
| CAP LIMIT MAX | Identifies the CAP limit (five-position numeric field) |
| G2172 AMT PAID | Identifies the amount paid to date to the provider for billing HCPCS G2172 (14 -position numeric field that displays dollar amounts, max of 999,999,999.99). |
| G2172 UNITS | Identifies how many units have been billed for HCPCS G2172 (five-position numeric field, max of 99999) |
| G2067-G2080 COST SHR AMT | Identifies the Cost Share Amount for billing HCPCS G2067-G2080 (14-position numeric field that displays dollar amounts, max of 999,999,999.99). This field will display zeroes. |
| G2067-G2080 UNITS | Identifies how many units have been billed for HCPCS G2067-G2080 (five-position numeric field, max of 99999) |
| G2086-G2088 COST SHR AMT | Identifies the Cost Share Amount for billing HCPCS G2086-G2088 (14-position numeric field that displays dollar amounts, max of 999,999,999.99) |
| G2086-G2088 UNITS | Identifies how many units have been billed for HCPCS G2086-G2088 (five-position numeric field, max of 99999) |
| G2215-G2216 COST SHR AMT | Identifies the Cost Share Amount for billing HCPCS G2215-G2216 (14-position numeric field that displays dollar amounts, max of 999,999,999.99) |
| G2215-G2216 UNITS | Identifies how many units have been billed for HCPCS G2215-G2216 (five-position numeric field, max of 99999) |
| G1028 COST SHR AMT | Identifies the Cost Share Amount for billing HCPCS G1028 (14-position numeric field that displays dollar amounts, max of 999,999,999.99) |
| G1028 UNITS | Identifies how many units have been billed for HCPCS G1028 (five-position numeric field, max of 99999) |
Posted 8/21/2023