[Provider] HIPAA Code Updates

[Provider Notification]

The following HIPAA Code Sets have been updated in MaineCare's claims
processing system.  The changes will go into effect on Wednesday, July
1.

 

Code Type

Code

Explanation

Condition Code (Added) 

Code 42

Continuing care not Related to inpatient hospitalization.

Claims Adjustment Reason Code (End Dated)

Code 17

This code has been cross-walked to Code 16

Requested information was not provided or was insufficient / incomplete.

UB Claim Form Bill Type, Bill Classification (Clinics Only)  *These
codes were added but MeCMS cannot process these bill types.

Code 5

 

 

Code 2

Comprehensive outpatient rehabilitation facilities (CORFs)

 

Hospice (hospital-based)

 

 

**Not all of the codes that are published are used by MaineCare.  Please
continue to follow MaineCare billing instructions that can be found by
clicking on the following link 

http://www.maine.gov/dhhs/oms/providerfiles/billing_instructions.html

 

 

 

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MaineCare up to date so your Remittance Statements and checks arrive on
time.  Call Provider Enrollment at 1-800-321-5557 Option #6.  

 

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This is a one-way communication.  Do not reply to this e-mail.  Your
e-mail will not receive response.  If you have questions, please call

1-800-321-5557.

 

 

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