evekhm/cms_iom_3000 huggingface dataset:
(Claims Processing)

Duplicates21 100.8 B-01-13,B-02-029  Durable Medical Equipment 21 100.9     Failure to Furnish Information 21 100.10 Foot Care21 100.11 Transfer of Claims21 100.12 Hearing Aids21 100.13 B-00-67,AB-01-159  Skilled Nursing Facility 21 100.14 Laboratory21 100.15 Medical Necessity21 100.16 B-01-10,A-01-132, A-01-69, AB-01-79, B-01-21 Miscellaneous21 100.17 Non-Physician Services21 100.18 Preventive Care21 100.19 Hospital Based Physicians21 100.20 Benefit Limits21 100.21 Restriction to Coverage21 100.22 Split ClaimsNew Chap. New Sect. Int.  Pub. 13 Carrier Pub. 14 PMs Other Description 21 100.23                                                        Surgery21 100.24     Fraud and Abuse Section (Help Stop Fraud) 21 100.25     Time Limit for Filing 21 100.26 Vision21 100.27 Hospice21 100.28     Mandatory Assignment for Ph ysician Services Furnished for Medicaid Patients 21 100.29     Medicare Secondary Payer (MSP) 21 100.30     Reasonable Charge and Fee Schedule 21 100.31 Adjustments21 100.32 Overpayments / Offsets21 100.33 Ambulatory Surgical Care21 100.34   B-01-21  Patient Paid / Split Payment 21 100.35     Supplemental Coverage / Medigap 21 100.36 Limitation of Liability21 100.37 Deductible / Coinsurance21 100.38 General Information Section21 100.39     Home Health Messages (Section 41)  21 100.40     Add-On Messages - Section 39 21 100.41     Mandated Messages - Section 40 New Chap. New Sect. Int.  Pub. 13 Carrier Pub. 14 PMs Other Description 21       100.42 B-00-48,AB-01-30, AB-01-97, AB-01-149 Demonstration Project21 Add. A     Addendum A EOMB/MSN Crosswalk
(Medicare Claims Processing Manual Crosswalk)

Medicare Claims Processing Manual Chapter 22  Remittance Advice Crosswalk  New Chap.  New Sect.  Int. Pub,13-3  Carrier Pub. 14-3  Program Memos Description 22                                              10 B3-7030 A-01-057, A-03-005,AB-03-026 Background 22 20 A3-3750   General Remittance Completion Requirements 22 30A-01-057, A-02-070, AB-02-067, B-01-35 Remittance Balancing 22 40 A3-3750 Electronic Remittance Advice22 40.1 A3-3750A-02-070, AB-02-067, AB-03-060 ANSI ASC X12N 835 22 40.2   AB-02-067 Generating an ERA if Required Data is Missing or Invalid 22 40.3 A3-3751 A-01-057, A-02-070,AB-02-067, B-01-35 Electronic Remittance Advice Data Sent to Banks 22 40.4 A3-3751 A-01-057 Medicare Standard  Electronic PC-Print Software 22 40.5   A-01-57 835 Implementation Guide 22 50 A3-3754 B3-3024.5 A-01-057, A-01-93,B-01-076 Standard Paper Remittance Advice Notices 22 50.1 A-02-012, B-02-023,R1763B3 The Do Not Forward (DNF) Initiative 22 50.2 A3-3754 SPR FormatsNew Chap.  New Sect.  Int. Pub,13-3  Carrier Pub. 14-3  Program Memos Description 22 50.2.1 A3-3754  A-00-36 Part A/FI SPR Format 22 50.2.2    Part B/Carrier and DMERC SPR Format 22 50.3 A3-3754   FI SPR Crosswalk to the 835 22 50.4   B-01-076 Carrier and DMERC SPR Crosswalk to the 835 22                     60 Remittance Advice Codes(section heading only) 22 60.1 A-02-070, AB-02-067,AB-02-142,  AB-01-132, AB-03-012 Standard Adjustment Reason Codes 22 60.2 AB-02-142, AB-01-132,AB-02-067, AB-03-012, AB-03-095  Remittance Advice Remark Codes 22 60.3 B3-7030.2 Group Codes22 60.4   AB-02-142, AB-03-012 Requests for Additional Codes 22 70 A3-3754  B-02-050 FI ERA Requirement Changes to Accommodate OPPS and HH PPS 22 70.1 A3-3753   Scope of Remittance Changes for HH PPS 22 70.2 A3-3753   Payment Methodology of the HH PPS Remittance: HIPPS Codes 22 70.3 A3-3753   Items Not Included in HH PPS Episode Payment 22 70.4 A3-3753   835 Version 3051.4A.01 Line Level Reporting Requirements for the Request for Anticipated Payment (RAP) Payment for an Episode 22 70.5 A3-3753   835 Version 3051.4A.01 Line Level Reporting Requirements for the Claim Payment in an Episode (More Than Four Visits)  New Chap.  New Sect.  Int. Pub,13-3  Carrier Pub. 14-3  Program Memos Description 22 70.6 A3-3753   835 Version 3051.4A.01 Line Level Reporting Requirements for the Claim Payment in an Episode (Four or Fewer Visits) 22 70.7   A-02-103 PPS Partial Episode Payment (PEP) Adjustment
(Medicare Claims Processing Manual)

3180 R138CP  04/09/2004  Beta Testing COB Implementation  07/06/2004  3218 R107CP  02/24/2004  Intermediaries and Intermediary Shared System Maintainers must make necessary changes to implement the HIPAA X12N 837 Institutional 837 transaction 07/06/2004  3031 R099CP  02/09/2004  Contractors and shared systems maintainers must make necessary changes to implement the HIPAA X12N 837 coordination of benefits transaction  07/06/2004  3100 R098CP  02/06/2004  Implementation of National COB Process for Crossover Claims  07/06/2004  3109 R086CP  02/06/2004  Required pre- pass editing processes to prevent certain  claim errors from being accepted into the Part B and DMERC shared systems  07/06/2004  3050 R084CP  02/06/2004  Allowing segments to be transmitted in any order  07/06/2004  3095 R057CP  01/02/2004  Accommodating 15 Positions of ISA08 Data on Outbound X12N HIPAA Transactions 04/05/2004  3001 Rev #  Issue Date  Subject  Impl Date  CR#  R049CP  12/19/2003  Intermediary Rejection of HIPAA X12N 837 Health Care Claim Transaction When Certain Levels of Errors Are Detected  04/05/2004  2879 R044CP  12/19/2003  Mandatory Electronic Submission of Medicare Claims Based on the Administrative Simplification Compliance Act and Waiver Conditions 01/20/2004  2966 R015CP  10/31/2003  Accommodating 15 Positions of ISA08 Data on Outbound X12N HIPAA Transactions 04/05/2004  2819 R001CP  10/01/2003  Initial Publication of Manual NA NA Back to top of chapter
(Medicare Claims Processing Manual Crosswalk)

Medicare Claims Processing Manual  Chapter 26 - - Completing and Proce ssing Form CMS-1500 Data Set  Crosswalk New Chapter New Section Int. Pub 13-3 Carrier  Pub 14-3 Other Program  Memo Description 26                        10 B3-3002,B3-4020, B4-2010, B3-3005.1.B, B3-3005.4   Health Insurance Claim Form CMS-1500 26 10.1  Returning a Claim as Unprocessable 26 10.2 B3-3005.2B3-3005.4 B3-4020.1 B4-2010.1  TR-1712  Items 1 - 11 - Patient and Insured Information 26 10.3 B3-3005.2,B3-3005.4, B3-4020.1, B4-2010.1   Items 11a - 13 - Patient and Insured Information 26 10.4 B3-3005.4,B3-4020.2, B4-2010.2,   TR-1712, TR-1718 B-03-045, AB-03-091,  -B-00-15, B-98-28,  Items 14-33 - Provider of Serv ice or Supplier Information 26 10.5 B4-2010.3, PM-98-28, B-02-55               B-03-040  Place of Service Codes (POS) and Definitions New Chapter New Section Int. Pub 13-3 Carrier  Pub 14-3 Other Program  Memo Description                                                  26 10.6 B3-4020.3,  Carrier Instructions for Place of Service (POS) Codes 26 10.7 B3-4020.4  TR-1783  B-03-030 Type of Service (TOS) 26 10.8 B3 -2207  Requirements for Specialty Codes 26 10.8.1  Assigning Specialty Codes by Carriers and DMERCs 26 10.8.2  Physician Specialty Codes 26 10.8.3 B3-2207.1  Nonphysician Practitioner, Supp lier, and Provider Specialty Codes 26 10.9 B3-3002  Obtaining Copies of the Form CMS-1500 26 20 B3-3005.3,B3-3999   Form CMS-1500 - Data Element Matrix 26 30 B3-3002,B3-4020, B4-2010, B3-3002, B3-3003, B3-3042, B3-7563   Paper Claims 26 Exh 1 AB-02-132 Instructions for the Retrieva l of the Current HCPCS via CMSs Mainframe Telecommunications System (Formerly Network Data Mover)
(Medicare Claims Processing Manual)

Benefits Contractor (COBC) Detailed Error Report File Layouts 10/03/2005  4042 R586CP  06/17/2005  Modification to the National Coordination of Benefits Agreement (COBA) File Transfer and Financial Reporting Processes 10/03/2005  3906 R474CP  02/11/2005  Detailed Error Report Notification Process to COBA Partners  07/05/2005  3709 R448CP  01/21/2005  Timeframe for Execution of Crossover Agreements and Update on the Transition to the National Coordination of Benefits Agreement (COBA ) Program  02/22/2005  3658 R250CP  07/23/2004  Update of CWF Procedures 01/03/2005  3404 R158CP  04/30/2004  Transition to Medicare Coordination of Benefits Contractor (COBC) 10/04/2004  3273 R138CP  04/09/2004  Transition to Medicare Coordination of Benefits Contractor (COBC)  07/06/2004  3218 R098CP  02/06/2004  Transition to Medicare Coordination of Benefits Contractor (COBC)  07/06/2004  3109  Rev #  Issue Date  Subject  Impl Date  CR#  R001CP  10/01/2003  Initial Publication of Manual NA NA Back to top of Chapter
(Medicare Claims Processing Manual Crosswalk)

Medicare Claims Processing Manual  Chapter 28 - Coordination With Medigap, Medicaid, and Other Complementary Insurers Crosswalk Chap.                                                 Sect. Int.Pub.13. Carrier Pub. 14 HO Pub. 10 P.M. ROOffice  Manual Description 28 10 B3-4700 Medigap - Definition and Scope 28 20 B3-4702,B3-3047    Assignm ent of Claim s and Transfer Policy  28 20.1 B3-4702.1,B3-3047, B4-2110.1    Beneficiary  Insurance Assignm ent Selection 28 30 B1-2010,B3-4702 A-01-20,A-01-63  Com pletion of the Claim  Form  28 30.1 B1-2010,B3-4702 A-01-20,A-01-63  Form  CMS-1500 (ANSI X12N 837 COB (Version 4010)) 28 30.2 A3-3604  HO-460   UB-92 (Form  CMS-1450) 28 40 B3-4703 AB-99-3,AB-01-155 MSN Messages28 50 B3-4704 AB-99-3,B-01-35, A-01-57  Rem ittance Notice Messages 28 60  B3-4705  AB-99-3  Returned Medigap Notices  Chap. Sect. Int.  Pub.13. Carrier Pub. 14 HO Pub. 10 P.M. RO  Office  Manual Description 28                          70 A1-1601,A3-3768 - A3-3769 B1-4607, B3-4701, B3-4706    Coordination of Medicare with Medigap and Other Com plementary  Health Insurance Policies 28 70.1 A1-1600-A1-1602.5, A3-3768, A3-3769  B1-4600 - B14602.5, B3-10010    Authorization for Release of Inform ation 28 70.1.1      Requests for Additional Inform ation 28 70.1.2   HO-91.3   Release of Title XVIII Claim s Inform ation for Medigap Insurance Purposes by  Providers 28 70.2 A3-3769     Integration of Title XVIII Claim s Processing with Com plementary  Insurance Claim s Processing 28 70.2.1 Program  Recognition28 70.2.2 A3-3769C Records and Inform ation28 70.2.3 A3-3769D     Matching Files Against Medicare Claim s Files 28 70.3 A1-1600 B1-4601    Standard Medicare Charges for COB Records 28 70.4  B1-4607    General Guidelines for Interm ediary  or Carrier Transfer of Claim s Inform ation to Medigap Insurers 28 70.5 A1-1601C B1-4601 Audits Chap. Sect. Int.  Pub.13. Carrier Pub. 14 HO Pub. 10 P.M. RO  Office  Manual Description 28                                             80 B3-4707 A-01-20,A-01-63, B-01-06  Electronic Transm ission - General Requirem ents 28 80.1 A-01-20 HIPPA Provisions  Affecting Medigap Transactions 28 80.2      ANSI X12N 837 COB (Version 4010) Transaction Fee Collection 28 80.3 B3-4709,B4-2110.1    Medigap Electronic Claim s Transfer Agreem ents 28 80.3.1 A-01-20,A-02-069,  A-02-077,  A-02-078,  AB-02-20  Interm ediary  Crossover Claim  Requirem ents 28 80.3.2 B-01-32,B-01-06  Carrier/DMERC Crossover Claim  Requirem ents 28 90 B3-4708 Paper Subm ission28 100 A-00-23 RO-2700 Mediga p Insurers Fraud Referral 28 110 RO-2700 Medigap Crim inal Penalties/Ty pes of Com plaints under Subsection 1882(d) 28 110.1     RO-2700 Outline of Com plaint Referral Process  Chap. Sect. Int.  Pub.13. Carrier Pub. 14 HO Pub. 10 P.M. RO  Office  Manual Description 28 110.2                 RO-2700 Prelim inary  Screen ing and Referral to Regional Office of the Inspector General 28 110.3     RO-2700 CMS Regional Office Quarterly  Report on Medicare Supplem ental Health Insurance Penalty  Provision Activity  28 110.3.1 RO-2700 Statistics28 110.3.2 RO-2700 Narrative
(Medicare Claims Processing Manual Crosswalk)

Medicare Claims Processing Manual Chapter 31 - ANSI X12N Formats Other than Claims  or Remittance New Chap New Sect Int Pub. 13-3 Carrier  Pub 14 Program  Memo Description 31 1    Purpose of Chapter 31 10   PM AB 03-36 ANSI X12N 270/271 Im plem entation and Direct Date Entry (DDE)  Eligibility 31 10.1   PM AB 03-36 Background 31 10.2   PM AB 03-36 Eligibility Queries Options and W orkflow 31 10.3   PM AB 03-36 Eligibility Query Types 31 10.4   PM AB 03-36 Interm ediary and Carrier Responsibilities 31 10.5   PM AB 03-36 Data Center Responsibilities 31 10.6   PM AB 03-36 Provider/Network Service Vendors Responsibility 31 10.7   PM AB 03-36 Supplem ental CW F Module Inform ation 31 10.8   PM AB 03-36 Eligibility Queries Options and W ork Flows 31 20   PM AB 01-06 ANSI X12N 276/277 Claim s Status Request/Response Transaction Standar 31 20.1   PM AB 01-06 Transm ission Requirem ents 31 20.1.1   PM AB 01-06 Batch Transactions 31 20.1.2   PM AB 01-06 Online Direct Data Entry (DDE 31 20.1.3   PM AB 01-06 Interactive/Online (Non-DDE) 31 20.2   PM AB 01-06 Summary of the 276/277 Process for Carriers, DMERCs and Interm ediaries 31 20.3   PM AB 01-06 Flat Files  1New Chap New Sect Int Pub. 13-3 Carrier  Pub 14 Program  Memo Description 31 20.4   PM AB 01-06 Translation Requirem ents 31 20.5   PM AB 01-06 Transm ission Mode 31 20.6   PM AB 01-06 Restriction and Contro lling Access to Claim s Status Inform ation 31 30   PM B-00-68 Furnishing Claim s  Inform ation to Com plementary Insurers Under HIPAA 31 40   PM B- 02-53 ASC X12N 278 - Electroni c Referral Certification and Authorization 31     50 web pagereference Related Internet Files Routinely Updated by CMS   2