Information Releases

• 5/24/2012 - Update to Medicaid Crossover Claims
• 5/3/2012 - Update to Medicaid Crossover Claims
• 3/5/2012 - Completing the Transition from 4010 to 5010
• 2/6/2012 - Completion of Transition to 5010
• 1/9/2012 - ICD-10 Readiness

General Information

• 11/10/2011 - 5010 Implementation Overview
• 9/15/2011 - 5010 Testing Notice
• 02/06/2012 - FAQ
• 11/1/2011 - FAQ

Companion Guides

• 270/271 – Health Care Eligibility Benefit Inquiry and Response
• 276/277 – Health Care Claim Status Request and Response
• 277U - Unsolicited Claim/Encounter Status Notifications
• 820 - Payroll Deducted and Other Group Premium Payment for Insurance Product 
• 824 - Application Advice
• 834 - Benefit Enrollment and Maintenance
• 835 - Health Care Claim Payment/Advice
• 837D - Fee For Service Dental Claim
• 837I - Fee For Service Institutional Claim
• 837P - Fee For Service Professional Claims
• TA1 Transmission Acknowledgement
• TA3 Interchange Delivery Notice

Encounter Companion Guides

• 837D - Encounter Dental Claim
• 837D - MyCare Encounter Dental Claim
• 837I - Encounter Institutional Claims
• 837I - MyCare Encounter Institutional Claim
• 837P - Encounter Professional Claim
• 837P - MyCare Encounter Professional Claim
• 277U – MyCare Unsolicited Claim/Encounter Notifications
• 824 – MyCare Application Advice
• NCPDP D.0 - Pharmacy Encounter
• NCPDP D.0 – MyCare Pharmacy Encounter

NCPDP
For all NCPDP-formatted claims (including Medicare crossovers and TPL claims), the provider needs to submit the claim via the Pharmacy Point of Sale (POS) vendor.
 

HIPAA Compliant Codes
Crosswalk from Medicaid Local Codes to HIPAA Compliant Codes and Modifiers for Specificed Providers for Physcians, APNS, Clinics, Limited Practitioners, Excluding Injection and DME Codes - A guide to providers to indicate what the new HIPAA Compliant codes will be when local level codes are discontinued. In the documents, the effective date for each of the new codes is specifically indicated. Please see the rule number that is indicated for each code for more detail.
 

Additional Resources

• CMS web page
• Washington Publishing