(Medicare Claims Processing Manual Crosswalk)

Medicare Claims Processing Manual Chapter 2 - Admission and Registration Requirements Crosswalk New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 HO Pub.10 SNF Pub. 12 HH Pub. 11 PM                       Other Description2 01 Purpose of Chapter2 05        Definition of Provider and Supplier 2 10 HO-300,HO-312     General Admission and Registration Rules 2 10.1 A3-3502 B3-3200,B3-3203 HO-304.4     Health Insurance Claim Numbers (HICNs) 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 Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 HO Pub.10 SNF Pub. 12 HH Pub. 11 PM Other Description 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,HO-307 SNF-407    Request for Payment Should be Obtained 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 Entitlement2 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 Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 HO Pub.10 SNF Pub. 12 HH Pub. 11 PM Other Description 2              20.1 HO-301 SNF-401 A-03-031 Provider Development of Medicare Secondary Payer 2 30 A3-3503 HO-304,HP-311 SNF-404    Provider/Supplier Obtaining/Verifying the 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 Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 HO Pub.10 SNF Pub. 12 HH Pub. 11 PM Other Description 2                                       30.6.2 B3-6100.2  Carrier Implementation2 30.6.3 B3-6100.3  Data Format2 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 Deleted2 30.8 A3-3510       Health Insurance Master Record (HIMR) Inquiry 2 30.9 A3-3511 Deleted2 30.10 A3-3512 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fBeneficiary Master Information 2   30.11 A3-3513 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fMedicare Secondary Payer Information (MSP) 2   30.12 A3-3514 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fGroup Health Organization (GHO) 2   30.13 A3-3515 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fHospice Enrollment 2   30.14 A3-3516 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fSurgery Information 2   30.15 A3-3517 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fEnd Stage Renal Disease (ESRD) New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 HO Pub.10 SNF Pub. 12 HH Pub. 11 PM Other Description 2   30.16 A3-3518 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fBeneficiary Cross-Reference 2   30.17 A3-3519 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fDMEPOS Certificate of Medical Necessity (CMN) Display 2   30.18 A3-3520 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fTrue Not In File (TNIF) Status 2   30.19 A3-3521 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fClaim History Information 2  30.19.1  A3-3521.1 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fInpatient History Overview 2  30.19.2  A3-3521.2 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fOutpatient/HHA History Inquiries 2  30.19.3  A3-3521.3 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fHospice History 2  30.19.4  A3-3521.4 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fPart B History 2   30.20 A3-3522 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fArchived 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 Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 HO Pub.10 SNF Pub. 12 HH Pub. 11 PM Other Description 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 Reply2 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 RegistrationProcedures 2 90.1 HO-350A Patient Identification2 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 BillNew Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 HO Pub.10 SNF Pub. 12 HH Pub. 11 PM Other Description 2 90.5   HO-350E     Definition of Diagnostic Services 2                                       90.6 HO-350F Definition of Encounter2 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 Selection2 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 Requirements2 120.2 AB-00-30 Revocation of Election2 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)