Administrative Simplification Basics Fact Sheets
The Centers for Medicare & Medicaid Services (CMS) National Standards Group (NSG) announces the release of a series of fact sheets explaining the basics of HIPAA Administrative Simplification transactions and code sets. The fact sheets are designed to help the health care industry understand the purpose of HIPAA adopted transactions and to explain which standards and operating rules govern each transaction.
Claim Status Transactions (PDF)
– describes the claim status inquiry and response transaction and provides information on the adopted standard and operating rules
Code Sets (PDF)
– describes the purpose of code sets and provides information on Administrative Simplification code sets
D.0 Final Rule
The Department of Health & Human Services (HHS) announces the January 24, 2020, Federal Register publication of the Final Rule (FR) CMS-0055-F, which modifies the requirements for use of the National Council for Prescription Drug Programs (NCPDP) Telecommunication Standard Implementation Guide, Version D, Release 0, August 2007, by requiring the use of the Quantity Prescribed (460-ET) field to identify partial fills for Schedule II drugs.
For more information, read the full information bulletin on the Go-to-Info page.