Centers for Medicare & Medicaid Services Spreadsheets for 5010A1 Edits Updated

The 999 and 277CA edit spreadsheets that are maintained by the Centers for Medicare & Medicaid Services (CMS) have been updated. The spreadsheets are located on the CMS Web site http://www.cms.gov at the following link http://www.cms.gov/MFFS5010D0/20_TechnicalDocumentation.asp. 5010A1 quarterly updates for October 2011 were noted on the second tab "Change Log". The "Edit Reference" column indicates the specific edit affected and the "Change" column will give a brief description of the change to the edit.

The following edits will also be affected but will not be included in this version's "Change Log" tab.

• Update 5010 edit X222.494.2440.FRM.035 to change the referenced value from FRM05 to FRM03.
  The new edit logic will read: If 2440.LQ = "484.03" and 2440.FRM01 = "1A" and FRM03 >= 55.5 and <= 59.4, occurrences of 2440.FRM with FRM01 = "07", "08" and "09" are required.
  
  
• Update 5010 edit X222.494.2440.FRM03.125 to remove value "1B" from the FRM01 criteria and add the value of "6A". T
  The new edit logic will read: If 2440.LQ02 = '484.03" and 2440 FRM with FRM01 = "1A", "6A", "02", "03" or "05" is present, then 2440.FRM03 must be present.
  
  
• Update 5010 edit X222.494.2440.FRM04.045 to add the value of "6C" to the existing logic.
  The new edit logic will read: If 2440.LQ02 = '484.03" and 2440 FRM with FRM01 = "1C" or "6C" is present, then 2440.FRM04 must be present.
  
  
• Add the new 5010 edit X222.494.2440.FRM05.060 to verify responses are provided appropriately for questions "1B" and "6B".
  The new edit logic will read: If 2440.LQ02 = '484.03" and 2440 FRM with FRM01 = "1B" or "6B" is present, then 2440.FRM05 must be present.
  Error will be received on the 277CA Transaction Acknowledgement as CSCC A8, with CSC 21 and CSC699.

Post Date 09/20/11

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