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Publication # 100-04
Title Medicare Claims Processing Manual

 


 
Downloads

Chapter 1 - General Billing Requirements [PDF, 4 MB]
Chapter 1 Crosswalk [PDF, 485 KB]

Chapter 2 - Admission and Registration Requirements [PDF, 280 KB]
Chapter 2 Crosswalk [PDF, 355 KB]

Chapter 3 - Inpatient Hospital Billing [PDF, 4 MB]
Chapter 3 Crosswalk [PDF, 376 KB]

Chapter 4 - Part B Hospital (Including Inpatient Hospital Part B and OPPS) [PDF, 941 KB]
Chapter 4 Crosswalk [PDF, 353 KB]

Chapter 5 - Part B Outpatient Rehabilitation and CORF/OPT Services [PDF, 337 KB]
Chapter 5 Crosswalk [PDF, 120 KB]

Chapter 6 - SNF Inpatient Part A Billing [PDF, 493 KB]
Chapter 6 Crosswalk [PDF, 177 KB]

Chapter 7 - SNF Part B Billing (Including Inpatient Part B and Outpatient Fee Schedule) [PDF, 875 KB]
Chapter 7 Crosswalk [PDF, 98 KB]

Chapter 8 - Outpatient ESRD Hospital, Independent Facility, and Physician/Supplier Claims [PDF, 858 KB]
Chapter 8 Crosswalk [PDF, 333 KB]

Chapter 9 - Rural Health Clinics/Federally Qualified Health Centers [PDF, 260 KB]
Chapter 9 Crosswalk [PDF, 198 KB]

Chapter 10 - Home Health Agency Billing [PDF, 286 KB]
Chapter 10 Crosswalk [PDF, 203 KB]

Chapter 11 - Processing Hospice Claims [PDF, 320 KB]
Chapter 11 Crosswalk [PDF, 104 KB]

Chapter 12 - Physicians/Nonphysician Practitioners [PDF, 391 KB]
Chapter 12 Crosswalk [PDF, 314 KB]

Chapter 13 - Radiology Services and Other Diagnostic Procedures [PDF, 158 KB]
Chapter 13 Crosswalk [PDF, 217 KB]

Chapter 14 - Ambulatory Surgical Centers [PDF, 120 KB]
Chapter 14 Crosswalk [PDF, 134 KB]

Chapter 15 - Ambulance [PDF, 452 KB]
Chapter 15 Crosswalk [PDF, 81 KB]

Chapter 16 - Laboratory Services [PDF, 450 KB]
Chapter 16 Crosswalk [PDF, 144 KB]

Chapter 17 - Drugs and Biologicals [PDF, 641 KB]
Chapter 17 Crosswalk [PDF, 118 KB]

Chapter 18 - Preventive and Screening Services [PDF, 961 KB]
Chapter 18 Crosswalk [PDF, 192 KB]

Chapter 19 - Indian Health Services [PDF, 230 KB]

Chapter 20 - Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) [PDF, 674 KB]
Chapter 20 Crosswalk [PDF, 256 KB]

Chapter 21 - Medicare Summary Notices [PDF, 842 KB]
Chapter 21 Crosswalk [PDF, 427 KB]

Chapter 22 - Remittance Advice [PDF, 442 KB]
Chapter 22 Crosswalk [PDF, 89 KB]

Chapter 23 - Fee Schedule Administration and Coding Requirements [PDF, 533 KB]
Chapter 23 Crosswalk [PDF, 219 KB]

Chapter 24 - General EDI and EDI Support Requirements, Electronic Claims and Coordination of Benefits Requirements, Mandatory Electronic Filing of Medicare Claims [PDF, 530 KB]
Chapter 24 Crosswalk [PDF, 160 KB]

Chapter 25 - Completing and Processing the Form CMS-1450 Data Set [PDF, 675 KB]
Chapter 25 Crosswalk [PDF, 165 KB]

Chapter 26 - Completing and Processing Form CMS-1500 Data Set [PDF, 643 KB]
Chapter 26 Crosswalk [PDF, 46 KB]

Chapter 27 - Contractor Instructions for CWF [PDF, 677 KB]
Chapter 27 Crosswalk [PDF, 170 KB]

Chapter 28 - Coordination With Medigap, Medicaid, and Other Complementary Insurers [PDF, 445 KB]
Chapter 28 Crosswalk [PDF, 147 KB]

Chapter 29 - Appeals of Claims Decisions [PDF, 1,542 KB]
Chapter 29 Crosswalk [PDF, 104 KB]

Chapter 30 - Financial Liability Protections [PDF, 1.05 MB]
Chapter 30 Crosswalk [PDF, 228 KB]

Chapter 31 - ANSI X12N Formats Other Than Claims or Remittance [PDF, 321 KB]
Chapter 31 Crosswalk [PDF, 84 KB]

Chapter 32 - Billing Requirements for Special Services [PDF, 668 KB]

Chapter 33 - Miscellaneous Hold Harmless Provisions [PDF, 592 KB]

Chapter 34 - Reopening and Revision of Claim Determinations and Decisions [PDF, 606 KB]

Chapter 35 - Independent Diagnostic Testing Facility (IDTF) [PDF, 48 KB]

Chapter 36 - Competitive Bidding [PDF, 161 KB]

Chapter 37 - Department of Veterans Affairs (VA) Claims Adjudication Services Project [PDF, 42 KB]

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Last Modified Date : 12/05/2008
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