100-04 Medicare Claims Processing Manual: Chapter 21 Crosswalk
us-cms-medicare-manuals-pub-100-04-clm104c21crosswalk100-04 Medicare Claims Processing Manual: Chapter 21 CrosswalkGuidance
Medicare Claims Processing Manual Chapter 21 - Medicare Summary Notices New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 PMs Other Description 21 10 A-00-95, B-00-72, A-97-8, AB-98-31, B-98-4, A-99-48, AB-01-23 General MSN Requirements 21 10.1 A3-3726 A-99-48, A-01-54 General Requirements for the Medicare Summary Notice (MSN) 21 10.2 Correction/Reissuance of Faulty MSNs 21 10.3 A-99-48 Carrier and Intermediary Instructions for Preparing Medicare Summary Notice 21 10.3.1 A3-3726.1 AB-98-31 General Requirements - MSN 21 10.3.2 A3-3726.2 BB3-7003 Basic Concepts and Approaches 21 10.3.3 A3-3726.3 B3-7004 Format for the MSN 21 10.3.4 A3-3726.4 B3-7006 Technical Specifications for the Medicare Summary Notice (MSN) 21 10.3.5 A3-3726.5 B3-7006.1 AB-98-31, AB-02-106 Title Section of the MSN 21 10.3.6 A3-3726.6 B3-7006.2 A-00-36 Claims Information Section 21 10.3.7 A3-3726.7 B3-7006.3 Message Section
New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 PMs Other Description 21 10.3.8 A3-3726.8 B3-7006.4 AB-02-106 Appeals Section 21 10.3.9 A3-3726.9 B3-7006.5 Continuation Page 21 10.3.10 MSN Calculations 21 10.3.10.1 A3-3726.10 Intermediary Calculations 21 10.3.10.2 B3-7007.1 Carrier Calculations 21 10.3.11 A3-3726.11, A3-3726.11 B3-7008, B3-7008 A-00-58, A-01-93 Back of the MSN - Carriers and Intermediaries 21 10.3.12 A3-3726.12 B3-7010 Separation of Claim Line Items on MSN 21 10.3.13 A3-3726.13 B3-7011 Suppression of Claims from MSNs 21 20 Specifications for Spanish MSN 21 20.1 B3-7006.6 AB-02-106 Spanish MSN 21 20.2 Disclaimer Section 21 20.3 B3-7006.7 Title Section 21 20.4 B3-7006.8 Claims Information Section 21 20.5 B3-7006.9 Message Section 21 20.6 B3-7006.10 AB-02-106 Appeals Section 21 20.7 B3-7006.11 A-99-48 Text and Specifications for Spanish MSN Back 21 20.7.1 Carrier Spanish MSN Back 21 20.8 A-99-48, A-01-93 Intermediary Spanish MSN Back 21 30 Exhibits
New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 PMs Other Description 21 30.1 A3-3726.13 Intermediary Exhibits 21 30.2 B3-7012 Carrier Exhibits 21 40 A3-3726.14 B3-7013 Explanatory and Denial Messages 21 50 A3-3726.14A B3-7014 AB-02-106 Categories and Identification Numbers for Approved MSN Messages 21 50 B-02-047, AB-02-155, AB-02-151 Categories and Identification Numbers for Approved MSN Messages 21 50.1 Ambulance 21 50.2 Blood 21 50.3 Chiropractic 21 50.4 ESRD 21 50.5 Name/Number/Enrollment 21 50.6 Drugs 21 50.7 B-02-047 Duplicates 21 50.8 B-01-13, B-02-029 Durable Medical Equipment 21 50.9 Failure to Furnish Information 21 50.10 Foot Care 21 50.11 A3-3110 Transfer of Claims 21 50.12 Hearing Aids 21 50.13 B-00-67, AB 01 159 Skilled Nursing Facility
New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 PMs Other Description AB-01-159 21 50.14 Laboratory 21 50.15 AB-01-79, AB-02-155, A-03-068 Medical Necessity 21 50.16 B-01-10, B-01-21, AB-01-79, A-01-69, A-01-132 Miscellaneous 21 50.17 AB-03-057 Non-Physician Services 21 50.18 AB-02-010 Preventive Care 21 50.19 Hospital Based Physicians 21 50.20 AB-02-151 Benefit Limits 21 50.21 Restriction to Coverage 21 50.22 Split Claims 21 50.23 Surgery 21 50.24 AB-02-106 Fraud And Abuse Section (Help Stop Fraud) 21 50.25 Time Limit For Filing 21 50.26 Vision 21 50.27 Hospice
New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 PMs Other Description 21 50.28 Mandatory Assignment for Physician Services Furnished for Medicaid Patients 21 50.29 MSP 21 50.30 Reasonable Charge And Fee Schedule 21 50.31 Adjustments 21 50.32 Overpayments/Offsets 21 50.33 Ambulatory Surgical Care 21 50.34 B-01-21 Patient Paid / Split Payment 21 50.35 Supplemental Coverage / Medigap 21 50.36 Limitation of Liability 21 50.37 Deductible/Coinsurance 21 50.38 AB-02-106 General Information Section 21 50.41 Home Health Messages 21 50.42 AB-00-30 Religious Nonmedical Health Care Institutions 21 60 Add-On Messages 21 70 Mandated Messages 21 80 B-00-48, AB-01-30, AB-01-97, AB-01-14 Demonstration Project
New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 PMs Other Description 21 90 A3-3110 A-99-48, B-02-047 Spanish Messages 21 90.1 Ambulancia 21 90.2 Sangre 21 90.3 Quiropráctico 21 90.4 Deficiencia Renal Terminal 21 90.5 Número/Nombre/Inscripción 21 90.6 Drogas 21 90.7 B-02-047 Duplicados 21 90.8 B-01-13, B-02-029 Equipo Médico Duradero 21 90.9 Falta De Información Sometida 21 90.10 Cuidado De Los Pies 21 90.11 A3-3110 Reclamaciones Transferidas 21 90.12 Audifonos 21 90.13 B-00-67, AB-01-159 Instalacion De Enfermeria Especializada 21 90.14 Laboratorios 21 90.15 AB-01-79, AB-02-155, A-03-068 Necesidad Medica
New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 PMs Other Description 21 90.16 B-01-10. AB-01-79, B-01-21, A-01-69, A-01-132 Miscelaneo 21 90.17 AB-03-057 Servicios Que No Fueron Prestados Por Doctores 21 90.18 AB-02-010 Cuidado Preventivo 21 90.19 Servicios Medicos Prestados En Un Hospital 21 90.20 AB-02-151 Limites En Los Beneficios 21 90.21 Restricciones A La Cobertura 21 90.22 Reclamaciones Separadas 21 90.23 Cirugia 21 90.24 AB-02-106 Mensajes Para Ayudar A Detener El Fraude 21 90.25 Tiempo Limite De Enviar La Reclamacion 21 90.26 Vision 21 90.27 Hospicio 21 90.28 Asignacion Mandatoria 21 90.29 MSP 21 90.30 Cargos Razonables 21 90.31 Ajustes 21 90.32 Sobrepagos
New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 PMs Other Description 21 90.33 Cuidado Quirurgico Ambulatorio 21 90.34 B-01-21 Patient Paid / Split Payment 21 90.35 Cubierta Suplementaria/ Medigap 21 90.36 Reclamaciones Cuando Se Acepta Asignación 21 90.37 Deducible/Coaseguro 21 90.38 AB-02-106 Seccion De Información General 21 90.39 Section 39-Spanish “ADD-ON” Messages 21 90.40 Section 40-Spanish “Mandated” Messages 21 90.41 HHA - Agencia De Servicios De Salud En El Hogar 21 90.42 AB-00-30 Servicios De Cuidado De Salud No Medico Religioso 21 90.43 AB-01-30 Projecto Especial (Demostraciones) 21 90.43 AB-01-30, AB-01-97, AB-01-149 Projecto Especial (Demostraciones) 21 100 AB-98-59 Detailed Map From MSN to ANSI X12 Remittance Message Codes 21 100.1 Ambulance 21 100.2 Blood 21 100.3 Chiropractic 21 100.4 ESRD 21 100.5 Name/Number Enrollment 21 100.6 Drugs
New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 PMs Other Description 21 100.7 Duplicates 21 100.8 B-01-13, B-02-029 Durable Medical Equipment 21 100.9 Failure to Furnish Information 21 100.10 Foot Care 21 100.11 Transfer of Claims 21 100.12 Hearing Aids 21 100.13 B-00-67, AB-01-159 Skilled Nursing Facility 21 100.14 Laboratory 21 100.15 Medical Necessity 21 100.16 B-01-10, A-01-132, A-01-69, AB-01-79, B-01-21 Miscellaneous 21 100.17 Non-Physician Services 21 100.18 Preventive Care 21 100.19 Hospital Based Physicians 21 100.20 Benefit Limits 21 100.21 Restriction to Coverage 21 100.22 Split Claims
New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 PMs Other Description 21 100.23 Surgery 21 100.24 Fraud and Abuse Section (Help Stop Fraud) 21 100.25 Time Limit for Filing 21 100.26 Vision 21 100.27 Hospice 21 100.28 Mandatory Assignment for Physician Services Furnished for Medicaid Patients 21 100.29 Medicare Secondary Payer (MSP) 21 100.30 Reasonable Charge and Fee Schedule 21 100.31 Adjustments 21 100.32 Overpayments / Offsets 21 100.33 Ambulatory Surgical Care 21 100.34 B-01-21 Patient Paid / Split Payment 21 100.35 Supplemental Coverage / Medigap 21 100.36 Limitation of Liability 21 100.37 Deductible / Coinsurance 21 100.38 General Information Section 21 100.39 Home Health Messages (Section 41) 21 100.40 “Add-On” Messages - Section 39 21 100.41 Mandated Messages - Section 40
New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 PMs Other Description 21 100.42 B-00-48, AB-01-30, AB-01-97, AB-01-149 Demonstration Project 21 Add. A Addendum A EOMB/MSN Crosswalk
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