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CMS Pub. 100-04 – Medicare Claims Processing Manual | Midpage
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100-04
CMS Pub. 100-04
Medicare Claims Processing Manual
Centers for Medicare & Medicaid Services
1 (Rev. 13593)
General Billing Requirements
2 (Rev. 12423)
Admission and Registration Requirements
3 (Rev. 13757)
Inpatient Hospital Billing
4 (Rev. 13702)
Part B Hospital (Including Inpatient Hospital Part B and OPPS)
5 (Rev. 11129)
Part B Outpatient Rehabilitation and CORF/OPT Services
6 (Rev. 13089)
Inpatient Part A Billing and SNF Consolidated Billing
7 (Rev. 10880)
SNF Part B Billing (Including Inpatient Part B and Outpatient Fee Schedule)
8 (Rev. 12979)
Outpatient ESRD Hospital, Independent Facility, and Physician/Supplier Claims
9 (Rev. 13547)
Rural Health Clinics/Federally Qualified Health Centers
10 (Rev. 13089)
Home Health Agency Billing
11 (Rev. 13190)
Processing Hospice Claims
12 (Rev. 13316)
Physicians/Nonphysician Practitioners
13 (Rev. 13150)
Radiology Services and Other Diagnostic Procedures
14 (Rev. 11927)
Ambulatory Surgical Centers
15 (Rev. 13464)
Ambulance
16 (Rev. 13746)
Laboratory Services
17 (Rev. 13255)
Drugs and Biologicals
18 (Rev. 13709)
Preventive and Screening Services
19 (Rev. 11427)
Indian Health Services
20 (Rev. 12557)
Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS)
21 (Rev. 13380)
Medicare Summary Notices
22 (Rev. 11427)
Remittance Advice
23 (Rev. 13610)
Fee Schedule Administration and Coding Requirements
24 (Rev. 13105)
General EDI and EDI Support Requirements, Electronic Claims and Coordination of Benefits Requirements, Mandatory Electronic Filing of Medicare Claims
25 (Rev. 12423)
Completing and Processing the Form CMS-1450 Data Set
26 (Rev. 12779)
Completing and Processing Form CMS-1500 Data Set
27 (Rev. 13314)
Contractor Instructions for CWF
28 (Rev. 13314)
Coordination With Medigap, Medicaid, and Other Complementary Insurers
29 (Rev. 12423)
Appeals of Claims Decisions
30 (Rev. 12934)
Financial Liability Protections
31 (Rev. 10236)
ANSI X12N Formats Other Than Claims or Remittance
32 (Rev. 13709)
Billing Requirements for Special Services
33 (Rev. 739)
Miscellaneous Hold Harmless Provisions
34 (Rev. 4219)
Reopening and Revision of Claim Determinations and Decisions
35 (Rev. 4473)
Independent Diagnostic Testing Facility (IDTF)
36 (Rev. 11427)
Competitive Bidding
37 (Rev. 11427)
Department of Veterans Affairs (VA) Claims Adjudication Services Project
38 (Rev. 10135)
Emergency Preparedness Fee-For-Service Guidance
39 (Rev. 13572)
Opioid Treatment Programs (OTPs)