Transcription of Medicare Claims Processing Manual
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Medicare Claims Processing Manual Chapter 26 - Comple ting and Proce ssing form CMS-1500 Data Set Table of Conte nts (Rev. 3881, 10-13-17) Transmittals for Chapter 26 10 - Health Insurance claim form CMS-1500 - Claims That Are Incomplete or Contain Invalid Information - Items 1-11 - P atient and Insured Information - Items 11a - 13 - P atient and Insured Information - Items 14-33 - P rovider of Service or Supplier Information - Place of Service Codes (P OS) and Definitions - A/B Medicare Administrative Contractor (MAC) (B) Instructions for Place of Service (POS) Codes - Type of Service (TOS) - Requirements for Specialty Codes - Assigning Specialty Codes by A/B MACs (B) and DME MACs - P hysician Specialty Codes - Nonphysician P ractitioner, Supplier, and P rovider Specialty Codes - Miles/Times/Units/Services (MTUS)
Form version 02/12: Leave blank. Item 9 - Enter the last name, first name, and middle initial of the enrollee in a Medigap policy if it is different from that shown in item 2.
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DATA ITEM DESCRIPTION Form Approved 2, DATA ITEM DESCRIPTION Form Approved, Data, National Uniform Claim Committee, Item, Description, CONTRACT DATA REQUIREMENTS LIST Form, FORM, CONTRACT DATA REQUIREMENTS LIST, Form Approved, STANDARD Architect-Engineer FORM SF, HR AIR FORCE TO 36A12, Hr air force to 36a12-1a-2091, HAND RECEIPT COVERING CONTENTS OF, Hand receipt covering contents of components