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Medicaid program; Medicaid Management Information System proposed system requirements--HCFA. Proposed notice
Abstract:
In this notice, we are proposing five new system requirements for Medicaid Management Information Systems. We propose that the systems be required to accept and use exclusively: (a) A uniform diagnostic coding system (the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM)), wherever diagnostic coding is used; (b) A common claim form for hospital billing (HCFA-1450); (c) A uniform electronic billing format for institutional billing; (d) A common claim form for noninstitutional providers (the revised version of the Health Insurance Claim Form, HCFA-1500); and (e) A uniform procedure coding system (HCFA Common Procedure Coding System (HCPCS)). These requirements would improve the efficiency and effectiveness of the Medicaid program.