CMS Resources Website
Versions 5010 and D.0
This website contains background, regulatory, educational, and implementation information.
Versions 5010 and D.0
This website contains background, regulatory, educational, and implementation information.
http://www.cms.gov/Versions5010andD0
Medicare Fee-for-Service (FFS) 5010 – D.0
Health Insurance Portability and Accountability Act (HIPAA) EDI standards, comparisons, and the Medicare
FFS Companion Guide (coming soon) are available on this website.
http://www.cms.gov/MFFS5010D0
Transaction and Code Sets Standards
Electronic transaction and code sets standards and information can be downloaded from this website.
http://www.cms.gov/TransactionCodeSetsStands
Electronic Billing & EDI Transactions Help Lines
Part A and B EDI Help lines are available on this website.
http://www.cms.gov/ElectronicBillingEDITrans
HIPAA Eligibility Transaction System (HETS) Help (270/271)
The HETS Help website is available to provide technical system support to CMS business partners
http://www.cms.gov/HETSHelp
The Accredited Standards Committee (ASC)
An online website for ASC X12 Implementation Guides and resources.
http://www.x12.org/
ASC X12 Interpretations Portal
This portal provides access to information about existing versions of ASC X12N Implementation Guides and
ASC X12 Technical Report Type 3 (TR3)
http://www.x12n.org/portal
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- Medical Billing Question and Answer - Terms
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- EVALUATION AND MANAGEMENT CPT code [99201-99499] - Full List
- Overall Medical billing process
- CPT Code 99201, 99202, 99203, 99204, 99205 - Which code to USE
- Internal Medical Billing Audit - how to do
Medical Billing Popular Articles
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Procedure CODES and Descriptions 99401 - Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an indi...
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CPT CODE AND Description 99391 - Periodic comprehensive preventive medicine reevaluation and management of an individual including an age... -
Medicare denial code and Descripiton 1 Deductible Amount 2 Coinsurance Amount 3 Co-payment Amount 4 The procedure code is inconsistent ...
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CPT code and description 80050 - General health panel This panel must include the following: Comprehensive metabolic panel (80053), ...
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Billed amount: It is the Amount charged for each service performed by the provider. In other words it is the total charge value of the cla...
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Procedure code and Description 99251 Inpatient consultation for a new or established patient, which requires these 3 key components: A pro...
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CPT Code and description 99381 - Initial comprehensive preventive medicine evaluation and management of an individual including an age an...
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Denial code co - 45 - Charges exceed your contracted/legislated fee arrangement. Note: This adjustment amount cannot equal the total servic...
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Background: Type of Service (TOS) is an indicator that the contractor places on the Form CMS-1500 paper form or electronic format. The indic...
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When an ERA is received, providers may: •Post decision and payment information automatically, for individual claims included in an R...
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