Transactions and Code Sets

CMS has issued new modifications to the implementation of the HIPAA 004010 transaction sets, the new version is 005010.The HIPAA 005010 transaction sets implementation date is January 1, 2012.

CMS has issued new modifications to the ICD-9 diagnosis and procedure code sets, the new codes set is ICD-10.The ICD-10 diagnosis code set will be implemented by October 2013.Additional implementation information will be available in the future.

If you wish to view any of the previous notices relating to the transactions or code sets, please visit the archives section of this page.

Overview

Federal Regulations

Medicaid Non-X12 Formats and Procedures

Medicaid Companion Guides for 005010

• Companion Guide 837 Institutional  (Last Updated: 02/14/2011)
• Companion Guide for 837 Professional(Last Updated: 02/14/2011)
• Companion Guide 837 Dental  (Last Updated: 02/14/2011)
• Companion Guide 837 Institutional Encounter (Last Updated: 11/01/2011)
• Companion Guide_ 837 Professional Encounter (Last Updated: 11/01/2011) 
• Companion Guide 837 Dental Encounter (Last Updated: 11/01/2011)
• Companion Guide 835 Remittance Advice (Last Updated: 02/14/2011)
• Companion Guide 820 Premium Payment (Last Updated: 07/28/2011)
• Companion Guide for 277 Health Care Claim Acknowledgment(Last Updated: 11/30/2011)
• Companion Guide for 270/271 Health Care Eligibility Benefit Inquiry and Response (Last Updated: 10/06/2011)

Medicaid Companion Guides for 004010

• Companion Guide for 837 Health Care Claim Institutional (Last Updated: 05/14/2007)
• Companion Guide for 837 Health Care Claim Professional (Last Updated: 01/24/2011)
• Companion Guide for 837 Health Care Claim Dental(Last Updated: 06/12/2007)
• Companion Guide for 837 Institutional Encounter(Last Updated: 02/27/2007)
• Companion Guide for 837 Professional Encounter(Last Updated: 02/27/2007)
• Companion Guide for 837 Dental Encounter (Last Updated: 02/27/2007)
• Companion Guide for 837 Institutional Medicare(Last Updated: 05/12/2005)
• Companion Guide  for 837 Professional Medicare (Last Updated: 10/16/2003)
• Companion Guide for 835 Remittance Advice(Last Updated: 04/12/2007)
• Companion Guide for 820 Premium Payment (Last Updated: 05/19/2003)
• Companion Guide for 270/271 Health Care Eligibility Benefit Inquiry and Response (Last Updated: 11/26/2007)

Testing Instructions

• Medicaid
• Children's Medical Services
• Kidney Disease Program
• Breast and Cervical Cancer Diagnoses and Treatment Program

Medicaid Submitter Enrollment and Agreement

• Maryland Medical Care Program Submitter Identification Form(Version004010)
• Maryland Medical Care Program Submitter Identification Form(Version 005010)
• Trading Partner Agreement