Payment Window Edit Corrections within the Common Working File (CWF)
It was recently determined that one of the revenue codes used in editing for the payment window was never implemented correctly since 1991. Revenue code 048X should only be bundled on the inpatient bill with certain specified HCPCS codes. Also, in terms of the one day pay window, CWF is editing for an exact match of provider numbers. However, the provider numbers will not match exactly when the hospital is a distinct part unit of a hospital, so CWF has not been editing appropriately in this scenario. Therefore, we will modify the edit to bundle with provider numbers with an 'S', 'T', 'R', or 'M' in the third digit of the provider number. CMS will also use this opportunity to clean up the manual section.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: October 21, 2005
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