(Medicare Claims Processing Manual Crosswalk)

Medicare Claims Processing Manual  Chapter 18 - Preventive and Screening Services Crosswalk Chap.                           Sect. Int.Pub 13 Carrier Pub. 14 PMs Other Description18 10 A3-3660.7,A3-3110 (partial),  A3-3157 (partial),  A3- 3192 (partial), B3-4480  SNF-536.2, SNF-534.A,  RHC-614, HSP-303.6.A, B, HO-435.A, HHA-473.A, B,  HO-230.4.C, RHC-404 Pneumococcal Pneumonia, Influenza Virus, and Hepatitis B Vaccines 18 10.1 A3-3660.7,A3-A3-3110, A3-3157,  A3-3192, B3-4480    SNF-536.2.A, SNF-534.A,  RHC-614, HSP-303.6.A, B, HO-435.A, HHA-473.A, B,  HO-230.4.C, RHC-404 Coverage Requirements 18 10.1.1 See Above See Above  See Above Pneumococcal Pneumonia Vaccine (PPV) 18 10.1.2 See Above See Above  See Above Influenza Virus Vaccine 18 10.1.3 See Above See Above  See Above Hepatitis B Vaccine 18 10.2 A3-3660.7.B B3-4480.1,B3-2049.4 (partial),  B3-4480.4.C SNF-536.2.B, RHC-614,RHC-504.1.B, HSP-303.6.C, HO-435.B, HHA-473.C, HHA 219,   Billing Requirements 18 10.2.1 A3-3660.7,A3-3660. B3-4480.2,  B3-4480.3, SNF-536.2.C, HSP-303.6.D,HO-435.C, HHA-473, 7, SNF-534.D, E, HO-435.D-F, HHA-473.E-G, SNF-536.2.D, SNF-536.2.E  Healthcare Common Procedural Coding System (HCPCS) and Diagnosis Codes Chap. Sect. Int.  Pub 13 Carrier Pub. 14 PMs Other Description 18 10.2.2 A3-3660.7.D, E, I    Claims Submitted to Intermediaries 18 10.2.2.1 A3-3660.7    Intermediary Payment for Pneumococcal Pneumonia, Influenza Virus, and Hepatitis B Vaccines 18 10.2.2.2 A3-3660.7.G    Special Instructions for Independent and Provider-Based RHCs/FQHCs 18 10.2.3 A3-3660.7.H    Claims Submitted to Regional Home Health Intermediaries (RHHIs) 18 10.2.4 A3-3660.7.J, K    Claims Submitted by Hospices and Payment Procedures for Renal Dialysis Facilities (RDF 18       10.2.4.1    PR 1 2711.4 Hepatitis B Vaccine Furnished to ESRD Patients 18 10.2.5  B3-4480.10   Claims Submitted to Carriers 18 10.2.5.1     Carrier Indicators and for the Common Working File (CWF) 18 10.2.5.2 B3-4480.6.B3-4480.7   Carrier Payment Requirements Chap. Sect. Int.  Pub 13 Carrier Pub. 14 PMs Other Description 18                    10.3 A3-3660.7 B3-4480.8,B3 3001.1 (partial)  B3-4480.9,  B3-4481,  B3-4480.6.A, B3-4480.6.C, B3-4480.9  SNF-534.F, G, HSP-303.6.D, HO-435.G, H, HHA-473.H, I, SNF-536.2.F, Simplified Roster Bills for Mass Immunizers 18 10.3.1  B3-4480.8.C   Roster Bills Submitted to Carriers for Mass Immunization 18 10.3.1.1 B3-4481,B3-4481.C, B3-4481.D, B3-4481.E, B3-4481.F, B3-4481.G, B3-4481.H, B3-4481.I, B3-4481.J   Centralized Billing for Flu and Pneumococcal (PPV) Vaccines to Medicare Carriers 18 10.3.2 A3-3660.7.L,A3-3660.7.N    Claims Submitted to Intermediaries for Mass Immunizations of Influenza and PPV  18 10.3.2.1 A3-3660.7.M    Simplified Billing for Influenza Virus Vaccine and PPV Services by HHAs 18 10.3.2.2 A3-3660.7.M    Hospital Inpatient Roster Billing 18 10.3.2.3 A3-3660.7.N    Electronic Roster Claims 18 10.4 AB-02-014(CR1691),  CWF Release Documentation for July 02 Common Working File (CWF) Edits Chap. Sect. Int.  Pub 13 Carrier Pub. 14 PMs Other Description 18 10.4.1   See above See above CWF Edits on Intermediary Claims 18 10.4.2   See above See above CWF Edits on Carrier Claims 18 10.4.3   See above See above CWF A/B Crossover Edits for Intermediary and Carrier Claims 18 10.5   AB-01-155A  Medicare Summary Notice (MSN) 18                         20 A3-3660.10A3-3660.19 B3-4601.1, B3-13027, B3-4601  SNF-537, HO-451.A,  RHC-623.A, RHC-404, SNF-537, SNF-537.2,  SNF-537.2.A Screening Mammography Services 18 20.1 A3-3660.16 B3-4601.2D,B3-4601.3, SNF-537.1, SNF-537.1.A,SNF-537.1.B, SNF-537.1.D, SNF-538, HO-454, RHC-641  Mammography Quality Standards Act (MQSA) 18 20.1.1 SNF-537.1.C Under Arrangements18 20.2 A3-3660.16 B3-4601.2,B3-4601.2.C,  B3-5266, B3-266B.1.c, B3-5266B.2.c, or 5266B.3.c,  B3-5258 SNF-537.A-F, HO-451.B-F,RHC-623.B-E,   HCPCS and Diagnosis Codes for Mammography Services 18 20.2.1 A3-3660.10.B,A3-3660.20 B3-4601.2.B,  B3-4601.2.G,   Computer-Aided Detection (CAD) Add-on Codes Chap. Sect. Int.  Pub 13 Carrier Pub. 14 PMs Other Description 18               20.3 A3-3660.10.B, B3-4601.2,B3-4601.2.E, B3-5266,  B3-5266B.1.c, 5266B.2.c, or 5266B.3.c,  B3 5258 SNF-537.A-F, SNF-537.2.BHO-451.B-F, RHC-623.B-E, SNF-537.2.E  Payment 18 20.3.1 A3-3660.10.B,A3-3660.10.C B3-4601.2.E,    Payment for Services Prior to January 1, 2002 18 20.3.2 A3-3660.10.B B3-4601.2.F,   Payment for Services On and After January 1, 2002 18 20.3.2.1 See above See above   Outp atient Hospital Mammography Payment Table 18 20.3.2.2 A3-3660.19, B3-4601.2.A   Payment for Computer Add-on Diagnostic Mammograms 18 20.3.2.3  A3-3660.10B,A3-3610.22B2, A3-3660.10A    Critical Access Hospital Payment 18 20.3.2.3.1 See above    CAH Mammography Payment Table 18 20.3.2.4  See above     SNF Mammography Payment Table Chap. Sect. Int.  Pub 13 Carrier Pub. 14 PMs Other Description 18                      20.4 A3-3610.22,A3-3660.10.D, B3-4601.2,  B3-5266, B3-5266.B.1.c, 5266.B.2.c, or 5266.B.3.c,  B3-5258,  SNF-537.A-F, HO-451.B-F,RHC-623.B-E, SNF-537.2.C,  Billing Requirements - Intermediary Claims 18 20.4.1 A3-3660.10.D Rural Health  Clinics and Federally Qualified Health Centers 18 20.4.1.1 A3-3660.10.D    RHC/FQHC Claims With Dates of Service Prior to January 1, 2002 18 20.4.1.2 A3-3660.10.D    RHC/FQHC Claims With Dates of Service on or After January 1, 2002 18 20.4.2 A3-3660.10.E    Intermediary Requirements for Nondigital Screening Mammographies 18 20.4.2.1  A3-3660.10.E,A3-3660.10.F    Intermediary Data for CWF and Provider Statistical and Reimbursement Report (PS&R) 18 20.5 B3-4601.3,B3-4601.3.A    Carrier Processing Requirements 18 20.5.1 B3-4601.3.B    Part B Carrier Claim Record for CWF 18 20.5.2 B3-4601.2.J    Transportation Costs for Mobile Units 18 20.6 A3-3660.10.G,A3-3660.10.H B3-4601.2.H,  SNF-537.2.F Instructions When an Interpretation Results in Additional Films Chap. Sect. Int.  Pub 13 Carrier Pub. 14 PMs Other Description 18