Medicare Claims Processing Manual 
Chapter 2 - Admission and Registration Requirements 
Crosswalk 
New  New  Int.  Carrier  HO  SNF  HH  PM  Other  Description 
Chap.  Sect.  Pub. 13  Pub. 14  Pub.10  Pub. 12  Pub. 11 
2  01                Purpose of Chapter 
2  05                Definition of Provider and Supplier 
2  10      HO-300,           General Admission and Registration Rules 
HO-312 
2  10.1  A3-3502  B3-3200,  HO-304.4          Health Insurance Claim Numbers (HICNs) 
B3-3203 
2  10.1.1  A3-3502  B3-3205  HO-304.5          Changes to HICNs 
2  10.1.2    B3-3208            Contractor Procedures for Obtaining 
Missing or Incorrect Claim Numbers 
2  10.1.3      HO-304  SNF-404        Importance of HICNs 
2  10.2      HO-302  SNF-402        Prohibition Against Waiver of Health 
Insurance Benefits as a Condition of 
Admission 
2  10.3      HO-303  SNF-317        Requiring Prepayment as a Condition of 
Admission is Prohibited 
2  10.4      HO-303.2  SNF-317        When Prepayment May Be Requested  New  New  Int.  Carrier  HO  SNF  HH  PM  Other  Description 
Chap.  Sect.  Pub. 13  Pub. 14  Pub.10  Pub. 12  Pub. 11 
2  10.4      HO-303.3          Prepayment Rules (Deductible, 
Coinsurance, Noncovered Services) 
2  10.5      HO-300          Hospital and Skilled Nursing Facility 
(SNF) Verification of Prior Hospital Stay 
Information for Determining Deductible 
and Benefit Period Status 
2  10.6      HO-303.3  SNF-317        Hospitals May Require Prepayment for 
Noncovered Services 
2  10.7      HO-303,4  SNF-317        Compliance With Agreement 
2  10.8      HO-266,  SNF-407        Request for Payment Should be Obtained 
HO-307  in All Cases as Protective Application for 
Hospital Insurance Benefits 
2  10.9      HO-308          Intermediary Requests to Verify Patient's 
HICN 
2  10.10      HO-309          Intermediary Learns Beneficiary is an 
HMO Enrollee 
2  10.11      HO-310  SNF-410        Retroactive Entitlement 
2  10.12        SNF-414        SNF Verification of Prior Hospital Stay 
and Transfer Requirements 
2  20      HO-300  SNF-401        Obtaining Information to Determine 
Whether to Bill Medicare or Another 
Payer  New  New  Int.  Carrier  HO  SNF  HH  PM  Other  Description 
Chap.  Sect.  Pub. 13  Pub. 14  Pub.10  Pub. 12  Pub. 11 
2  20.1      HO-301  SNF-401      A-03-031  Provider Development of Medicare 
Secondary Payer 
2  30  A3-3503    HO-304,  SNF-404        Provider/Supplier Obtaining/Verifying the 
HP-311  HICN and Entitlement Status 
2  30.1  A3-3800.2  B3-6005.2            Cross-Reference of HICN 
2  30.2  A3-3501  B3-3200  HO-304.1          Health Insurance (HI) Card 
2  30.3  A3-3501  B3-3200  HO-304.2          Temporary Eligibility Notice 
2  30.4      HO-304.3          Certificate of Social Insurance Award 
2  30.5      HO-305          Medicare Summary Notice (MSN) 
2  30.6  3-3508  B3-6100            Provider Access to CMS and Carrier or 
Intermediary Eligibility Data 
2  30.6.1  3-3508.1  B3-6100.1            Rules for Accessing Eligibility Data 
2  30.6.1.1  3-3508.3              Part A Inquiry (HIQA) Screen Display 
2  30.6.1.2  A3-3508.4              Part A Inquiry Reply (HIQAR) Screen 
Display- 
2  30.6.1.3  A3-3508.5              Part A Inquiry (HUQA)Data 
2  30.6.1.4  A3-3508.6              Part A Inquiry (HUQAR) Reply Data 
2  30.6.1.5          HH-467.6      Health Insurance Query for Home Health 
Agencies HIQH)  New  New  Int.  Carrier  HO  SNF  HH  PM  Other  Description 
Chap.  Sect.  Pub. 13  Pub. 14  Pub.10  Pub. 12  Pub. 11 
2  30.6.2    B3-6100.2            Carrier Implementation 
2  30.6.3    B3-6100.3            Data Format 
2  30.6.4    B3-6100.4            Part B Eligibility Data Security 
Requirements 
2  30.6.5    B3-6100.5            CMS Standard Part B Eligibility Inquiry 
Flat File Specifications 
2  30.6.6    B3-6100.6            CMS Standard Part B Eligibility Response 
Flat File Specifications 
2  30.7                Deleted 
2  30.8  A3-3510              Health Insurance Master Record (HIMR) 
Inquiry 
2  30.9  A3-3511              Deleted 
2  30.10  A3-3512  http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pdfBeneficiary Master Information 
2  30.11  A3-3513  http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pdfMedicare Secondary Payer Information 
(MSP) 
2  30.12  A3-3514  http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pdfGroup Health Organization (GHO) 
2  30.13  A3-3515  http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pdfHospice Enrollment 
2  30.14  A3-3516  http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pdfSurgery Information 
2  30.15  A3-3517  http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pdfEnd Stage Renal Disease (ESRD)  New  New  Int.  Carrier  HO  SNF  HH  PM  Other  Description 
Chap.  Sect.  Pub. 13  Pub. 14  Pub.10  Pub. 12  Pub. 11 
2  30.16  A3-3518  http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pdfBeneficiary Cross-Reference 
2  30.17  A3-3519  http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pdfDMEPOS Certificate of Medical Necessity 
(CMN) Display 
2  30.18  A3-3520  http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pdfTrue Not In File (TNIF) Status 
2  30.19  A3-3521  http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pdfClaim History Information 
2  30.19.1  A3-3521.1  http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pdfInpatient History Overview 
2  30.19.2  A3-3521.2  http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pdfOutpatient/HHA History Inquiries 
2  30.19.3  A3-3521.3  http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pdfHospice History 
2  30.19.4  A3-3521.4  http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pdfPart B History 
2  30.20  A3-3522  http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pdfArchived History Information 
2  30.21  A3-3523  B3-6008            Requesting Assistance in Resolving 
Problem Areas in the Inquiry/Inquiry 
Response Procedures 
2  30.21.1  A3-3523.1              HMO-Related Master File Corrections 
2  30.22      HO-300          Provider Problems Obtaining Entitlement 
Information 
2  50                Critical Case Procedures - Establishing 
Entitlement Under Part A and B  New  New  Int.  Carrier  HO  SNF  HH  PM  Other  Description 
Chap.  Sect.  Pub. 13  Pub. 14  Pub.10  Pub. 12  Pub. 11 
2  60      HO-306          Provider Contacts with the SSO to Obtain 
the HICN 
2  60.1      HO-306.1          Information Required by the Social 
Security Office 
2  60.2      HO-306.2          The SSO Reply 
2  70                SSO Assistance in Resolving Entitlement 
Status Problems 
2  80      HO-312          Required Hospital Notice to Beneficiaries 
2  80.1      HO-312A          Notice to Beneficiaries of QIO Review of 
Care 
2  80.2      HO-312B          Notice to Beneficiary of QIO of Need for 
Continued Hospitalization 
2  80.3      HO-312.1          QIO Monitoring of Hospital Admission 
Notice to Beneficiaries 
2  90      HO-350          Outpatient Hospital Registration 
Procedures 
2  90.1      HO-350A          Patient Identification 
2  90.2      HO-350B          Determining Whom to Bill 
2  90.3      HO-350C          Source of Admission - Outpatient Hospital 
2  90.4      HO-350D          Type of Bill  New  New  Int.  Carrier  HO  SNF  HH  PM  Other  Description 
Chap.  Sect.  Pub. 13  Pub. 14  Pub.10  Pub. 12  Pub. 11 
2  90.5      HO-350E          Definition of Diagnostic Services 
2  90.6      HO-350F          Definition of Encounter 
2  100              HSP-201  Hospice Notice of Election 
2  100.1                FI Reply to Notice of Election 
2  100.1.3              HSP-302.2  FI Reply to Notice of Election 
2  110                ESRD Method Selection 
2  110.1                ESRD Method of Selection Transaction to 
CWF and Response 
2  120                Religious Nonmedical Health Care 
Institution (RNHCI) Admission 
2  120.1            AB-00-30    Election Requirements 
2  120.2            AB-00-30    Revocation of Election 
2  120.3            AB-00-30    Completion of the Uniform (Institutional 
Provider) Bill (Form CMS-1450) Notice 
of Election for RNHCI 
2  120.4            AB-00-30    Common Working File (CWF)