AUC 1st Quarter 2002 Update
The information contained in this document represents the major activities of the Minnesota AUC for the first quarter 2002. Any questions or concerns about the AUC can be directed to the Minnesota Department of Health at email@example.com
or (651) 282-6343.
AUC member organizations, in conjunction with the Insurance Federation
of Minnesota, submitted legislation to clarify Minnesota Statutes Section
62J.535, the Uniform Billing section, of the Minnesota Administrative
Simplification Act. This legislation clarifies that HIPAA non-covered
entities are not required to accept or submit HIPAA electronic transactions.
The legislation further states that if non-covered entities do want to
engage in electronic transactions, they do need to adopt and follow the
ANSI standards. The legislation amends Minnesota Statutes Section 62J.581,
by clarifying and giving a clear effective date for the uniform paper
remittance and explanation of benefits. Finally, the legislation amends
section 62J.51, the definition of the uniform dental billing form to clarify
that it is the most current version of the ADA dental claim form. Governor
Ventura signed this legislation into law on April 1. For the entire amendment
to 62J.535 go to: http://www.mhdi.org/auc/legislativeresources.htm
Compliance with Minnesota Statutes Section 62J
The AUC is asking all MN payers and providers to document the extent to
which they are in compliance with the billing formats specified in Minnesota
Statutes, Section 62J.52. A sub-group of the AUC will collect and analyze
the data in the 2nd quarter of 2002 and report to the full AUC.
Place of Service Code for Urgent Care
CMS (Centers for Medicare and Medicaid Services) has approved a new place
of service code for urgent care. In 1999, the AUC requested two new place
of service codes, one for urgent care office and one for urgent care hospital.
CMS created one code for Urgent Care Facility. Please note that not all
payers are able to accept the new place of service code at this time.
Check with individual payers for more specific information. For the full
definition of the new code go to: http://www.hcfa.gov/medicaid/posdata.pdf
The Data Definitions TAG completed
the units definition grid. The grid may be added to the HCFA 1500 manual
when it is published in the fall of 2002. The DD TAG is currently updating
the HCFA 1500 manual. The 5th Edition of the manual will be published
in the 4th quarter of 2002.
At the national level, CMS released the Model Compliance Plan for HIPAA
covered entities to file for an extension in accordance with the Administrative
Simplification Compliance Act (ASCA). This will be a permanent agenda
item for the AUC in 2002.
At the state level, HIPAA education
continued in the 1st quarter. The Minnesota Center for Health Care Electronic
Commerce (MCHEC) continued the HIPAA Education and Awareness Program.
Twelve cities around the state were selected as regional points to host
a series of one-day and half-day "HIPAA Essentials II" workshops.
More than 1,500 health care professionals that attended this round of
seminars. This seminar focused on the most important and immediate next
steps (beyond awareness) that organizations should be working on, including
gap analysis and implementation testing. For more information visithttp://www.mhdi.org/mchec/hipaa/index.html or call our HIPAA Workshop Hotline at (651) 917-6703.
The National Uniform Claim Committee (NUCC) conducted a gap analysis of
the paper claim and the electronic 837. As a result of this analysis,
the NUCC has recommend the development of a national HCFA 1500 manual.
The Minnesota HCFA1500 manual was forwarded to the committee for review
and potential use moving forward with the national manual.
EOB / REMIT Work Group
The EOB / REMIT work group continues to follow developments at the national
level on the HIPAA Transactions and Code Sets delay. The new MN legislation
makes the EOB / REMIT manual effective October 16, 2004. Stacey Scott,
DHS and Brenda Elfton, Mayo Clinic Co-Chair the EOB / REMIT Work Group.
Mental Health TAG
The Mental Health TAG continues to develop a standard outpatient mental
health and chemical health authorization form. The next step is to complete
a crosswalk to the electronic 278 HIPAA transaction.
The Dental TAG met and is in the process of updating the Minnesota dental
claim form manual. Minnesota Statutes, Section 62J.52, Subdivision 3 (b),
required the AUC to develop this manual.
The 2002 HCPCS Manual is complete and available at Minnesota's Bookstore.
Copies of the "Closed Item List" from January through December
2001 are now available on the AUC website at http://www.mhdi.org/auc/hcpcs.htm
This will be updated quarterly.
The NUBC (National Uniform Billing Committee) approved Minnesota's request
for revenue codes for a variety of alternate therapies (including massage
therapy, aromatherapy, biofeedback and acupuncture). The new codes will
be four digits, beginning with a "2" (2XXX) and are effective