CMS Manual System: Medicare Claims Processing Summary of Changes

February 24, 2004 CMS Manual System: Medicare Claims Processing Summary of Changes Shared systems changes are needed to process the 837 Institutional X12N HIPAA claim transaction correctly. A number of issues with Coordination of Benefits (COB) transactions with third party payers, including states, have emerged as Medicare has implemented HIPAA transaction and code set standards. Some of these issues stem from Medicare having unique claims processing rules that differ from those used by other payers. We made a number of system and data element changes to implement the HIPAA standards, but some issues were not evident until testing with COB . . .