Coding Requirements. 3.27.1 The MCO must use the most current version of the following coding sources: (A) Diagnosis codes obtained from the International Classification of Diseases, Clinical Modification (ICD-9-CM); (B) Procedure codes obtained from Physician’s Current Procedural Terminology (CPT) and from CMS’ Healthcare Common Procedure Coding System (HCPCS Level 2); (C) American Dental Association (ADA) current dental terminology codes as specified in Minnesota Statutes, § 62Q.78; and (D) National Drug Codes. (E) Current local home care codes including units of service. 3.27.2 The MCO and its subcontractors must utilize the coding sources as defined in this section and follow the instructions and guidelines set forth in the most current versions of HCPCS and CPT. 3.27.3 Neither the MCO nor its subcontractors may redefine or substitute these required codes. 3.27.4 HIPAA compliant codes must be submitted on encounter data.
Appears in 2 contracts
Sources: Contract for Minnesota Special Needs Basiccare Program Services, Contract for Minnesota Special Needs Basic Care Program Services
Coding Requirements. 3.27.1 (1) The MCO must use the most current version of the following coding sources:
(Aa) Diagnosis codes obtained from the International Classification of Diseases, Clinical Modification (ICD-9-CM);.
(Bb) Procedure codes obtained from Physician’s 's Current Procedural Terminology (CPT) and from CMS’ Healthcare Health Care Common Procedure Coding System (HCPCS Level 2);.
(Cc) American Dental Association (ADA) current dental terminology codes as specified in Minnesota Statutes, § §62Q.78; and.
(Dd) National Drug Codes.
(Ee) Current local home care codes and waiver codes, including units of service. The EW codes must be HIPAA compliant according to the most current published instructional Minnesota Department of Human Services (DHS) bulletin 09-69-02, or as required in subsequent bulletins.
3.27.2 (2) The MCO and its subcontractors must utilize the coding sources as defined in this section and follow the instructions and guidelines set forth in the most current versions of HCPCS and CPT.
3.27.3 (3) Neither the MCO nor its subcontractors may redefine or substitute these required codes.
3.27.4 (4) HIPAA compliant codes must be submitted on encounter data.
Appears in 2 contracts
Sources: Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services, Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services