Medi-Cal Claims Customer Service Office
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Medi-Cal Claims Customer Service Office: HIPAA-2 External Links
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Centers for Medicare & Medicaid Services
Electronic Billing and EDI Transactions
Downloads - CROSSWALKS BETWEEN 4010 and 5010 -
CMS is making the side-by-side comparison documents available to interested parties without guarantee and without cost. The documents are available for download in both Microsoft Excel and PDF formats. The comparisons were performed for Medicare Fee-for-Service business use and while they may serve other uses, CMS does not offer to maintain for purposes other than Medicare Fee-for-Service. Maintenance will be performed without notification, as needed to support Medicare Fee-for-Service.
- Professional Claim 837-P 4010A1 to 5010 Side by Side [PDF, 442KB]
- Institutional Claim 837-I 4010A1 to 5010 Side by Side [PDF, 372KB]
- Remittance 835 4010A1 to 5010 Side by Side [PDF, 91KB]
- Claim Status 276/277 4010A1 to 5010 Side by Side [PDF, 179KB]
- Eligibility 270/271 4010A1 to 5010 Side by Side [PDF, 313KB]
- NCPDP 5.1 to D.0 Side by Side [PDF, 28KB]
- Excel formats - Professional, Institutional, NCPDP claims [ZIP, 351KB]
- Excel formats - Remittance, Claim Status Inquiry and Response, Eligibility Inquiry and Response [ZIP, 310KB]
- CMS – Version 5010 & D.0 & 3.0 National Calls
Throughout the implementation of Version 5010, CMS has hosted a variety of national education calls that informed the provider community of the steps that they need to take in order to be ready for implementation. These calls also gave participants an opportunity to ask questions of CMS subject matter experts.
- CalOHII serves as the primary resource for state entities on health information privacy and the implementation of HIPAA regulations.
CalOHII has issued policy memorandum 2010-89 regarding companion guides. HIPAA-covered departments that produce companion guides need to evaluate new requirements for the development of companion guides. Refer to these links for more information.
- http://www.ohi.ca.gov/calohi/LinkClick.aspx?fileticket=BRPNsHVHyPY%3d&tabid=36
- ASC X12 Intellectual Property Use
- Companion Guide Principles – Guidelines and Conventions for the Development of Proprietary Companion Guides to supplement published ASC X-12 Implementation Guides
- Standard Companion Guide Transaction Information Template
