Health Insurance Portability and Accountability Act (HIPAA) American National Standards Institute (ANSI) X12-N 837 version 5010 Changes Necessary for Coordination of Benefits (COB) and other Coordination of Benefits Agreement (COBA) Process Revisions
Through this instruction, the Centers for Medicare and Medicaid Services (CMS) outlines preliminary changes necessary within the Medicare shared systems to support HIPAA ANSI X12-N 837 version 5010 COB transactions. The instruction also requires that all shared systems uniquely identify mass adjustment claims for COBA crossover "inclusion" purposes and recovery audit contractor (RAC) adjustment claims for COBA crossover "inclusion" and "exclusion" purposes. In addition, through
this instruction, all shared systems shall be required to identify claims uniquely targeted for Health Care PrePayment Plans (HCPPs) to ensure that contractors will not issue associated crossover information on Medicare Summary Notices (MSNs) and 835 Electronic Remittance Advices (ERAs) or other remittance advices in production.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: August 01, 2008
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