In its continuing effort to help trading partners transition to the new versions of standards adopted under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) for electronically exchanging health care transactions, Medicare FFS has the following closeout updates for the week of June 25, 2012:
* Remittance Advice (835) * Claims (837I and P) * Claim Status (276/277) * Coordination of Benefits (837) Remittance Advice (835) Medicare FFS has stated in previous communications that trading partners would be allowed an additional 30 days to complete the 835 remittance advice transaction transition. Medicare FFS' internal processes related to closeout activities for the 835 remittance transaction include the generation of the last Accredited Standards Committee (ASC) X12 Version 4010A1 835 data on July 31, 2012. Remittance Advice files from the last processing cycle will be available for retrieval upon conclusion of the July 31, 2012 batch cycle. Beginning August 1, 2012, the Medicare FFS program shall only produce the 835 remittance advice transaction in the ASC X12 Version 5010. Claims (837 I and P) All claims received after normal close of business cutoff times on June 29th must be in the ASC X12 Version 5010 or NCPDP Version D.0. Any Medicare FFS claims received in ASC X12 Version 4010 or NCPDP Version 5.1 after normal close of business cutoff times on June 29th will be rejected back to the submitter. The specific message you receive if a claim is rejected will depend on your MAC. A detailed list of 4010 rejection error messages by MAC<http://www.cms.gov/Medicare/Billing/MFFS5010D0/Important-4010-51-Rejection-Information.html> has been posted. Claim Status (276/277) The last Claim Status Inquiry will be accepted in version 4010 at the end of the business day on Friday, June 29th, 2012. Following that date, all Claim Status activity will be in ASC X12 Version 5010. Coordination of Benefits (837) CMS has directed its MACs, FIs and carriers to begin sending all claims to the Coordination of Benefits Contractor (COBC) in version 5010 as of June 29, 2012. This will ensure that all claims that the COBC will issue to COB payers as of its Monday July 2, 2012 evening crossover claims cycle will be properly transmitted in the version 5010 format. Therefore, all COB payers will have to be in version 5010 COB production by June 29, 2012. More Information: For more information on ASCX12 Version 5010 and NCPDP Version D.0, please visit the Versions 5010 and D.0<http://www.cms.gov/Versions5010andD0> website. ________________________________ If you know someone who would like to subscribe to a Medicare Fee-For-Service (FFS) provider listserv, go to http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads//MailingLists_FactSheet.pdf<http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MailingLists_FactSheet.pdf> and select the appropriate listserv to subscribe. If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/wa.exe?INDEX) to unsubscribe or to leave the appropriate listserv. Please DO NOT respond to this email. This email is a service of CMS and routed through an electronic mail server to communicate Medicare policy and operational changes and/or updates. Responses to this email are not routed to CMS personnel. Inquiries may be sent by going to (http://www.cms.gov/About-CMS/Agency-Information/ContactCMS/index.html). Thank you.
