Medicare
Fee-for-Service
Editing
The
lefts for Medicare and Medicaid
Services (CMS) is underway with
implementation activities to convert
from Health Insurance Portability
and Accountability Act (HIPAA)
Accredited Standards Committee
(ASC) X12 version 4010A1 to ASC
X12 version 5010 and National
Council for Prescription Drug
Programs (NCPDP) version 5.1 to
NCPDP version D.0.
As part
of this implementation, Medicare
Fee-for-Service (FFS) is utilizing
codes sets for editing of the
inbound ASC X12 version 5010 transactions. These
codes sets are listed in the ASC
X12 Technical Report Type 3 (TR3),
also known as an Implementation
Guide.
"Not
Otherwise Classified" (NOC)
Codes
To
meet the requirements of the TR3
for proper editing of the NOC
codes, Medicare created an NOC
code set for editing Medicare
transactions only. This
code set is generated using the
following code sets:
•
Annual American Medical
Association(AMA) Current Procedural
Terminology (CPT) Listing
•
Annual CMS Healthcare Common
Procedure Coding System (HCPCS)
Listing
•
Quarterly CMS HCPCS Listing
The
NOC code set consists of CPT and
HCPCS codes that meet the following
criteria:
•
Procedure code ends in "99"
and the procedure code has one
of the words or phrases in the
description:
*
Not Otherwise Classified;
*
Not Otherwise;
*
Unlisted;
*
Not Listed;
*
Unspecified;
*
Unclassified;
*
Not Otherwise Specified;
*
Non-specified;
*
Not Elsewhere Specified;
*
Not Elsewhere;
*
Nos (Note:
Includes "nos", "nos;",
"nos,");
*
Noc (Note:
Includes "noc", "noc;",
"noc,");
•
Procedure code has one of
the words or phrases in the description:
*
Not Otherwise Classified;
*
Not Otherwise;
*
Unlisted;
*
Not listed;
*
Unspecified;
*
Unclassified;
*
Not otherwise specified;
*
Non-specified;
*
Not elsewhere specified;
*
Not elsewhere;
*
Nos (Note:
Include "nos ", "nos;",
"nos,");
*
Noc (Note:
Include "noc ", "noc;",
"noc,");
Updates
Medicare
will be updating the code set
on a quarterly basis (January,
April, July, and October) as the
parent code sets are updated,
so be sure to check back for updates.
For a copy of the Revised January
2012 NOC Codes, per Medicare,
click here.
Information
on this page was last modified
by Medicare on 01/17/2012 12:33:46
PM
|
