(Medicare Claims Processing Manual Crosswalk)

Medicare Claims Processing Manual  Chapter 25 - Instructions for Completing UB-92, NSF, and Related ANSI X12 Formats Crosswalk New Chap. New Sect. Int. Pub. 13-3 Hospital Pub 10 Other              ProgramMemo   Description 25 10    AB-03-036 FI Implementation of the Health Insurance Portability and Accountability Act (HIPAA) Health Care Eligibility Benefit Inquiry/Response Transaction (270/271) Standard 25 20 A-01-20,A-01-63, B-00-68, B-01-06, B-01-32 Health Insurance Portability and Accountability Act (HIPAA) Health Care Claim and C oordination of Benefits 25 20.1    B-01-06 Decimal Data Elements 25 20.2    A-01-20 Transmission Mode - Inbound X12N837 HIPAA version claim 25 20.2    B-01-06 Transmission Mode - Inbound X12N837 HIPAA version claim 25 20.3    A-01-20 Free Billing Software 25 20.4    A-01-20 External Keyshop or Imaging Processing 25 20.5 A-01-20,B-01-06 Provider Direct Data Entry (DDE) New Chap. New Sect. Int. Pub. 13-3 Hospital Pub 10 Other Program   Memo Description 25                               20.6 A-01-20,A-01-63,  A-02-119 Edits Performed by the FI 25 20.7 A-01-20,A-01-63 Edits Performed by the Standard systems 25 20.8    A-01-63 Attachment Data Processing 25 20.9     Related Internet Files Routinely Updated by CMS 25 30 A-00-89,A-01-20, B-01-06 Coordination of Benefits 25 30.1    A-01-20 Transmission Mode - Outbound X12N 837 COB Transaction 25 30.1    B-01-06 Transmission Mode - Outbound X12N 837 COB Transaction 25 30.2    A-01-20 External Keyshop or Imaging Processing 25 30.3 A-01-20,B-01-06 Summary of Process 25 30.4    AB-02-54 Generating an Outbound Coordination of Benefits (COB) X12N 837 (4010) When Required Data is Missing or Invalid 25 30.5 A-01-20 Outreach25 50     Uniform Bill - CMS-1450 New Chap. New Sect. Int. Pub. 13-3 Hospital Pub 10 Other Program   Memo Description 25                         50.1 A3-3604  HO-460 HHA-475,HSP-302, OPT-416,  RDF-320, SNF-560  Uniform Billing With Form CMS-1450 25 50.2  HO-431.1 HHA-422  Disposition of Copies of Completed Forms 25 60 A3-3604,A3-3873.2   HO-461 HHA-475,OPT-416, RDF-320, SNF-560 A-03-032, A-03-059, R1894A3 General Instructions for Completion of Form CMS-1450 For Billing 25 70 A3-3606 HO-462   Form CMS-1450 Consistency Edits 25 80 A3-3664  HO-411.1,IM-HO-411.1, HO-415.11 HHA-445 Adjustments25 80.1 A3-3664B    General Rules for Submitting Adjustment Requests 25 80.1.1 A3-3664D    Adjustment Bills Involving Time Limitation for Filing Claims 25 80.1.2 HO-411.2,IM- HO-411.2 HHA-445  Claim Change Reasons 25 80.1.2.1     Claim Change Reason Codes 25 80.1.2.2     Edits on Claim Change Reason Codes 25 80.1.2.3 Additional EditsNew Chap. New Sect. Int. Pub. 13-3 Hospital Pub 10 Other Program   Memo Description 25               80.1.3 HO-411.2,IM-411.2 Late charges25 80.2 A3-3664,A3-3610.8  IM-HO-411.1, HO-415.11 HHA-445  Inpatient Part A Hospital Adjustment Bills 25 80.2.1 A3-3664.1A Tolerance Guidelines for Submitting Inpatient Part A Hospital Adjustment Requests 25 80.3     SNF Part A Adjustments 25 80.3.1   SNF-515.5  Adjustment to HIPPS Codes Resulting From MDS Corrections 25 80.3.1.1     Effective Date for Adjustment Billing 25 80.3.1.2   SNF-562  Tolerance Guides for Submitting SNF Inpatient Adjustment Requests  25 80.3.2     SNF Inpatient Paper Claims 25 80.3.3     SNF Inpatient Electronic Claims Using the UB-92 National Format (Version  060) 25 80.3.3.1     Billing Instructions-SNF Inpatient Electronic Claims Using the ANSI ASC X-12 837 (Version 3051) 25 80.3.3.2     Billing Instructions-SNF Inpatient Electronic Claims Using the ANSI ASC X-12 837 (HIPAA version) New Chap. New Sect. Int. Pub. 13-3 Hospital Pub 10 Other Program   Memo Description 25 80.3.4     Patient Does Not Return From SNF Leave of Absence, and Last Bill Reported Patient Status as Still Patient (30) 25 80.4     Hospital and SNF Part B Adjustment Requests 25 80.4.1     Guidelines for Submitting Adjustment Requests 25 80.5     Home Health Adjustments 25 80.5.1     Submitting Adjustment Requests 25 90     Provider Electronic Billing File and Record Formats - UB-92 Version 6 25 90.1     Recommended Physical F ile Specifications - Magnetic Tape 25                    90.2 File Specifications - Media Other Than Magnetic Tape 25 90.3 Record Specifications25 90.4     Key to Records 25 90.5 Record Layouts25 100     CMS-1450, UB-92, ANSI 837A 4010 and 3051 3A.01 Crosswalk of Data Elements New Chap. New Sect. Int. Pub. 13-3 Hospital Pub 10 Other Program   Memo Description 25 110 Add. A    Notes for Benefit Coordination 25 120     Coordination of Benefits Records - COB - I/O Records 25 130 Add. B    Alphabetic Listing of Da ta Elements Used in UB-92 Version 6 25 140     Home Health Data Elements - Cross Reference 25 Exh 1     Exhibit 1 - Heading Descriptions of Medicare Part A Claim/COB flat file layout (4010837i.xls)