CMS Manual System

1 CMS Manual System Department of Health & Human Services (DHHS) Pub 100-04 Medicare Claims Processing Centers for Medicare & Medicaid Services (CMS) Transmittal 1929 Date: March 9, 2010 Change Request 6801 Transmittal 1917, dated February 5, 2010, is being rescinded and replaced by Transmittal 1929, dated March 9, 2010 to remove obsolete information in section , Form Locator 15 and to add the code 2 title which is Clinic or Physician s Office . All other material remains the same. SUBJECT: Point of Origin for admission or Visit Codes Update to the UB-04 (CMS-1450) Manual Code List I.

2 SUMMARY OF CHANGES: The following Point of Origin for admission or Visit (formerly Source of admission ) codes, discontinued by the National Uniform Billing Committee (NUBC), will be discontinued for use by the Fiscal Intermediary Standard System (FISS): 7-Discontinued Effective July 1, 2010, B-Discontinued Effective July 1, 2010, C-Discontinued Effective July 1, 2010. Medicare systems changes for codes B and C are included in Change Request (CR) 6757. Medicare systems changes for Condition Code 47 (used to replace code B) are also included in CR 6757.

3 This CR updates the IOM language to Chapter 25 for Point of Origin for admission or Visit codes 7, B, C, and Condition Code 47. This CR also directs Medicare systems changes for code 7. Point of Origin for admission or Visit code 1"s, Chapter 25 example and definition has been updated. Point of Origin for admission or Visit code 2"s, Chapter 25 definition has also been updated. The processing of these codes is not being changed. New / Revised Material Effective Date: July 1, 2010 [NOTE: Unless otherwise specified, the effective date is the date of service.]

4 ] Implementation Date: July 6, 2010 Disclaimer for Manual changes only: The revision date and transmittal number apply only to red italicized material. Any other material was previously published and remains unchanged. However, if this revision contains a table of contents, you will receive the new/revised information only, and not the entire table of contents. II. CHANGES IN Manual INSTRUCTIONS: (N/A if Manual is not updated) R=REVISED, N=NEW, D=DELETED-Only One Per Row. R/N/D Chapter / Section / Subsection / Title R 25 Locators 1-15 R 25 Locators 16-30 III.

5 FUNDING: SECTION A: For Fiscal Intermediaries and Carriers: No additional funding will be provided by CMS; Contractor activities are to be carried out within their operating budgets. SECTION B: For Medicare Administrative Contractors (MACs): The Medicare Administrative Contractor is hereby advised that this constitutes technical direction as defined in your contract. CMS does not construe this as a change to the MAC Statement of Work. The contractor is not obligated to incur costs in excess of the amounts allotted in your contract unless and until specifically authorized by the Contracting Officer.

6 If the contractor considers anything provided, as described above, to be outside the current scope of work, the contractor shall withhold performance on the part(s) in question and immediately notify the Contracting Officer, in writing or by e-mail, and request formal directions regarding continued performance requirements. IV. ATTACHMENTS: Business Requirements Manual Instruction *Unless otherwise specified, the effective date is the date of service. Attachment - Business Requirements Pub. 100-04 Transmittal: 1929 Date: March 9, 2010 Change Request: 6801 Transmittal 1917, dated February 5, 2010, is being rescinded and replaced by Transmittal 1929, dated March 9, 2010 to remove obsolete information in section , Form Locator 15 and to add the code 2 title which is Clinic or Physician s Office.

7 All other material remains the same. SUBJECT: Point of Origin for admission or Visit Codes Update to the UB-04 (CMS-1450) Manual Code List Effective Date: July 1, 2010 [NOTE: Unless otherwise specified, the effective date is the date of service.] Implementation Date: July 6, 2010 I. GENERAL information A. Background: The following Point of Origin for admission or Visit (formerly Source of admission ) codes, discontinued by the National Uniform Billing Committee (NUBC), will be discontinued for use by the Fiscal Intermediary Standard System (FISS): 7 Discontinued Effective July 1, 2010 B Discontinued Effective July 1, 2010 C Discontinued Effective July 1, 2010 Medicare systems changes for codes B and C are included in Change Request (CR) 6757.

8 Medicare systems changes for Condition Code 47 (used to replace code B) are also included in CR 6757. This CR updates the Internet Only Manual (IOM) language to Chapter 25 for Point of Origin for admission or Visit codes 7, B, C, and Condition Code 47. This CR also directs Medicare systems changes for code 7. Point of Origin for admission or Visit code 1 s, Chapter 25 example and definition language has been updated. Point of Origin for admission or Visit code 2 s, Chapter 25 definition language has also been updated.

9 The processing of these codes is not being changed. B. Policy: Form Locator 15 (Point of Origin for admission or Visit) of the UB-04 and its electronic equivalence is a required field on all institutional inpatient claims and outpatient registrations for diagnostic testing services. This code indicates the point of patient origin for the admission or visit of the claim being billed. II. BUSINESS REQUIREMENTS TABLE Number Requirement Responsibility (place an X in each applicable column) A/B MAC DME MAC FI CARRIER RHHI Shared- System Maintainers OTHER FISS MCS VMS CWF Medicare systems shall no longer accept Point of Origin for admission or Visit code 7 on institutional claims.

10 X X COBC Number Requirement Responsibility (place an X in each applicable column) A/B MAC DME MAC FI CARRIER RHHI Shared- System Maintainers OTHER FISS MCS VMS CWF Contractors shall be aware of the IOM language updates to Chapter 25 for codes 1, 2, 7, B, C, and 47. X X X III. PROVIDER EDUCATION TABLE Number Requirement Responsibility (place an X in each applicable column) A/B MAC DME MAC FI CARRIER RHHI Shared- System Maintainers OTHER FISS MCS VMS CWF A provider education article related to this instruction will be available at shortly after the CR is released.