24.5.7 CMS-64 Implementation Log Exhibit The following exhibit documents changes implemented to the CMS-64 reporting subsystem. Ticket Number Project Memo Description Implementation Date RAT2855 151344 Modify logic to Report a new FCOS 17D for crossover claims 12/1/2015 RAT2677 Modify to reset indicator when CCare Claim assigned BASE Report Id; Added FRC116 to 88 Level 10/1/2015 RAT2655 150791 Modify CMS64 logic related to HCBW COEs and report assignment 10/1/2015 RAT2583 150651 Modify CMS64 to report Waiver related Financial claims according to FRC 10/1/2015 RAT2569 150600 Modify CMS64 to add Column Id for Miscellaneous Reports 10/1/2015 RAT2549 150564 Modify CMS64 to remove DEX and Admit Date from logic to determine CC vs BASE and prevent SCHP Report ID 6/29/2015 RAT2558 150588 Modify CMS64 to report expenditures for Renal Dialysis Clinics in FCOS 10 instead of 49 6/22/2015 RAT2398 150298 Modify CMS64 to include financial transactions for report MVNA 4/3/2015 RAT2240B 141807 Added COE 054 to COEs to report to BASE report 4/3/2015 the correction I found an omission in my code installed 3/6/2015. This was corrected. RAT2398 150298 Modify to include financial transactions for report MVNA 4/3/2015 RAT2343 150194 Modify cost center assignment percentage for cost center 86702 3/6/2015 RAT2325 150136 Modify to include Column E for MEG Waiver Reporting 3/6/2015 RAT2240 141807 Added COE 054 to COEs to report to BASE report 3/6/2015 RAT1957 Corrected for prior period processing in financial FCOS assignment 01/23/2014 RAT2125 Corrected errors in Family Planning Split Logic 11/17/2014 ICD10 ICD10 Changes 10/01/2014
RAT0330 111912 Create New Report IDs & FCOS AMENDED 0828/2013 Update 24D-5exhb-A with new section 24.5.6.2 Miscellaneous Reports Exhibit and associated table RAT0330 111912 Create New Report IDs & FCOS AMENDED 01/26/2013 Added New Exhibit 24.5.6.2 Miscellaneous Reports Exhibit RAT0330 111912 Create New Report IDs & FCOS AMENDED 01/26/2013 Create a total of seven new reports as outlined in the matrix attached to the amendment to memo 111912 (most recent version entitled: “Create New Report IDs & FCOS Amended 062812”). 64.9A BASE Summary 64.10 BASE Summary 64.9C2 64.9C1 64.S9 RAC 64.9A CMS21 Base RAT0468 120533 Modify CMS64 for Redefined Provider Type 8/2/2012 Modify description of provider type 343 to methadone clinic and assign to FCOS 10. Add provider type 342 to FCOS 49. RAT0469 120534 Report Presumptive Eligible Children on CMS 64.21 instead of CMS 64.9 7/5/2012 Remove presumptive eligible kids (cost center 86771) from the CMS 64 base report. Route cost center 86771 to CMS 64 SCHP report. After assigning FCOS, change cost center 86771 claims to CMS report id '6421'. RAT0250 N/A Reprocess rejected or bypassed claims back through the download program 6/11/2012 The DW fedcms64 table was loaded with 4,972 ‘Line 7-Prior Period Expenditures, Not Previously Reported’ records on 6/11/2012. RAT0461 N/A NMMJCX64 assigns incorrect prior period to encounters 5/10/2012 Check the sign of the CMS64 reimbursement determine whether a positive adjustment or negative adjustment report type code needs to be assigned for prior period. RAT0389 120289 Remove Audit related Financial Reason Codes from CMS64 Base 4/6/2012 Bypass audit related financial reason codes and claim adjustment reason codes. Also remove TPL report logic.
Provider Type and Specialty when determining the HCBW report ID. The Old logic looks at hard coded provider IDs. 9165 N/A data problem with SCHP claims 7/2/2010 An edit in the CMS64 program is incorrectly assigning a FCOS of 05A to certain Professional SCHP claims. This is incorrect. The correct FCOS for these claims should be FCOS 05. 7296 271190 Develop the CMS 64.9 Reports for SALUD and BH Programs (HCBW changes only); Implemented HCBW for 1915C 5/21/2010 Modify cms64 for one line change related to plog 7296. 7296 271190 Develop the CMS 64.9 Reports for SALUD and BH Programs (HCBW changes only); Implemented HCBW for 1915C 4/30/2010 8864 100046 Modify CMS64 Report to Bypass PERM Adjustments 2/18/2010 Temporary bypass for PERM adjustments Line 10b report is developed. N/A Email from Chris Pruett /Gary Gorczyca EMSA claims paid 10/01/09 - 12/31/09 not in CMS table 2/1/2010 Fedcms64 table updated for missing claims. 8675 291707 Update CMS64 Hardcoded Public Providers to Remove Amarillo Diagnostic Clinic Rx 1/25/2010 N/A from Chris Pruett Expired Fed COS '06' and '09' for BASE report 1/5/2010 For FFY/Quarter = 2010/1 Encounters processed have the 'paid' date' moved up a week in the download program. Those that were processed at the end of Sep, 2009, were allocated to FCOS 06 and 09, FCOS that were replaced beginning 10/1/2009. The fedcms54_tbl was updated to change those encounters to FCOS 06A and 09A. N/A Email from Chris Pruett Claims missed in prior downloads added to the fedcms64 table. 1/5/2010 For Retro FFY/Quarter = 2008/2 to 2009/24 Per Chris Pruett, these claims were already reported in prior quarters but these are being added so that the fedcms64 table agrees with the reports filed.
B-FED-MTCH-CD 7747 281089 Add columns to fedcms64 table 10/1/2008 7746 281089 Update FEDCMS64 Data Warehouse Table With New Fields - Pass SYSID, COE and FED-MTCH-CD to DW fedcms64 table 9/30/2008 7800 281200 CMS 64 Report and the 2009 ICD-9 Update - UPDATE 2009 DIAGNOSIS CODES by changing upper range from 669.99 to 679.14 9/30/2008 7708 N/A Modify the CMS64 to look at DRG code 767 instead of 374 for Family Planning; DRG for family planning changed from 374 to 767 for effective dates after 10/01/2007 7/24/2008 7716 280895 CMS 64 Reporting - Reverse PE System Logic of 28-0500 7/2/2008 Remove code that checks for FED CODE = '3' when assigning CMS64 Report ID and Column ID 7716 280895 Reverse 280500 changes for PE reporting and add adhoc report of PE expenditures 7/1/2008 For FFY/Quarter = 2008/3 • DW change - PE supp report developed initially in MS Access. MF reran qtr ended Jun08 with changes. Records sent down to DW for the table update. (Need added columns in fedcms64 table to add this report to supplemental Cognos reports.) • Mainframe Change - modified to not include COE 071/3 on the SCHIPS report 7658 280847 CMS Perm Recovery Project - PDCS 6/1/2008 Add adj reason code 082. Manual change to vvadjrsn table made for 082 7551 280500 COGNOS CMS64 Report Changes (PE expenditures) 4/18/2008 Added all code that assigns CMS64 Report ID's and Column ID's for BASE, FMPL and SCHP reports • Modified for the SCHIPs PE COE 071/3 to be included on The SCHIPS report • Also excluded rev code '001 'as total line PL7548
Apr08 N/A Added PT WV-P0204-C-PSYC-BACHLR 4/3/2008 Some undocumented changes use 'APR08' as tags in NMMJCX64. Add provider type 932 - PSYCHOLOGIST changes include – • added STATE PROVIDER SYSIN, PAID DATE SYSIN, • added read of DB record FPYBLETB, • added check for • check for F-RSN-CDs in Bypass Logic, • code to assign TPL report ID, Prior period report ID, Correct Last DOS for Institutional Claims 7551 280500 Remove PE expenditures from BASE report and include in SCHIP report 4/1/2008 For FFY/Quarter = 2008/3 see revised run for 280895 Indicators changed in download program to facilitate Cognos report redirection of claims. (Note: Mainframe changes made on 4/18/2008 and first two weeks of download files were rerun to update table.) 7546 280481 Run adhoc report for PE clients included in CMS64 reports 4/1/2008 For FFY/Quarter = 2008/3 Cheryl Gentsch developed MS Access queries. 7395 271598 Add CPT Code V2787 To The CMS 64 Report Criteria 3/27/2008 7476 280159 Change CMS 64 Criteria For FCOS 09 3/27/2008 7398 271601 Revise CMS64 Reporting Related To Adjustments and TPL 3/27/2008 Mainframe changes 7398 271601 Revise CMS64 Reporting Related To Adjustments and TPL 3/1/2008 For FFY/Quarter = 2008/2 DW change