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					Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
                                                                        Page i
______________________________________________________________________________


TO:         Host sites, STC Beta site, SSMs, and CMS
FROM:       Christopher Sheridan
DATE:       March 4, 2008
SUBJECT:    R2008200 Host Quarterly Release Document

The R2008200 Host Quarterly Release Document is being sent to Host sites, STC
Beta site, SSMs, and CMS today, March 4, 2008.

This release is scheduled to be in production on April 7, 2008. Don Moon is the
Release Coordinator, and Vinay Vuyyuru is the Assistant Release Coordinator.
They are working with Kathy Woytan, who is coordinating this release for CMS.

Special Notes:

   1. The following CMS CRs will not be delivered at this time. It is
      anticipated that they will be delivered in the R20082AF Follow-Up Release
      on 03/07/2008:

      00025660 - 5790 CLINICAL TRIAL POLICY UPDATE
      00025694 - 5779-NATIONAL COMPETITIVE BIDDING NCB) PHASE V

   2. The following CMS CRs are dependant upon the delivery of the two CRs cited
      above:

      00025641 - 5757-ADDL CWF EDITING FOR SNF CB PART II
      00025668 - 5805-NEW MODIFIERS WHEN BILLING IN CLINICAL RESEARCH STUDIES

   3. The Final PMs have not been received for the following CRs, so they can
      not be delivered:

      00025819   -   5913   NEW WAIVED TEST
      00025831   -   5977   TYPE OF SERVICE CORRRECTIONS
      00025838   -   5980   APRIL UPDATES TO 2008 MPFSBD
      00025841   -   5981   NEW HCPCS CODES FOR APRIL 2008 UPDATE

   4. CR 00025600 - REWRITE ITF PROGRAM HIIDCCOP will not be delivered with the
      April release. It will be rescheduled for a later release.

   5. Production Problem 00025859 - HIMR TRAINING SCREEN DISPLAYING BAD DATA is
      being delivered with this release. This delivery provides the extra
      testing this Problem needs.




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2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
                                                                       Page ii
______________________________________________________________________________


   6. The CWF User Documentation updates are not completed for the following
      CRs. The updates will be included with the version of the Documentation
      sent with the Final Release:

      00025598   -   5699_REPORTING OF HEMATOCRIT AND HEMOGLOBIN TEST RESULTS
      00025660   -   5790-CLINICAL TRIAL POLICY UPDATE
      00025668   -   5805-NEW MODIFIERS WHEN BILLING IN CLINICAL RESEARCH STUDIES
      00025694   -   5779-NATIONAL COMPETITIVE BIDDING (NCB) PHASE V

   7. These CRs listed in Section VII.C. represent analysis-only efforts. There
      are no software deliverables for the April release with these CRs.

If you have any questions regarding this document, contact Don Moon at (443)
436-6786, or Vinay Vuyyuru at (443) 436-6719.

Thank you.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
                                                                      Page iii
______________________________________________________________________________


TABLE OF CONTENTS


I.    RELEASE OVERVIEW .......................................................1

      A.   RELEASE DOCUMENT STRUCTURE........................................1

      B.   DOCUMENTATION UPDATES AND REVISIONS...............................3

      C.   NSC (NO SYSTEM CHANGES) CHANGE REQUESTS...........................6

      D.   RE-ASSIGNED CHANGE REQUESTS.......................................7

      E.   COMBINED CHANGE REQUESTS..........................................8

II.   SPECIAL INFORMATION ....................................................9

      A.   CWF SYSTEMS DOCUMENTATION CHANGES.................................9

      B.   CHANGES REQUIRING SATELLITE SYSTEM MODIFICATIONS.................10

      C.   EDIT MODIFICATIONS BY CHANGE REQUEST.............................11

      D.   SYSTEMS MODIFICATIONS TO HIMR....................................14

III. TECHNICAL INFORMATION .................................................26

      A.   IMPACT TEST......................................................26

      B.   ADDED/ARCHIVED MODULES...........................................27

IV.   PRE-PRODUCTION ACTIVITY ...............................................30

      A.   HOST PRE-PRODUCTION ACTIVITY.....................................30

      B.   SPECIAL INSTALLATION INSTRUCTIONS................................31

      C.   SPECIAL NOTES....................................................32

V.    CONNECT:DIRECT CONTENTS - FILE STATISTICS .............................33

VI.   TESTING DATA IN CURRENT RELEASE .......................................35



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2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
                                                                       Page iv
______________________________________________________________________________


VII. DETAILED DESCRIPTION OF CHANGES .......................................39

      A.        HOST CHANGE REQUEST..............................................39
           1.     00023761 ITF CORRECTION ISSUES ...............................39

      B.     SATELLITE CHANGE REQUESTS........................................50
           1.  00025445 PART A ADJUSTMENTS ON ADD HISTORY EDITS IN ERROR ON TRNG
                          AUX ................................................50
           2. 00025520 RECEIVING 7261 IN ERROR .............................58
           3. 00025567 CLAIMS LOOPING WITH U5340 ...........................60
           4. 00025598 5699 - REPORTING OF HEMATOCRIT AND HEMOGLOBIN TEST
                          RESULTS ............................................63
           5. 00025623 HCPCS G0141 SETTING 7172 INCORRECTLY WHEN MULT. DIAG ON
                          CLM ................................................69
           6. 00025634 CR7245 SETTING INCORRECTLY ON NON-COVERED ANTI-EMETIC74
           7. 00025640 5756 REVISION TO CR 4294 LOW VISION REHAB DEMO ......76
           8. 00025641 5757- ADDL CWF EDITING FOR SNF CB PART II ...........87
           9. 00025648 5766 - MODIFICATIONS TO THE CWF COBA CLAIMS SELECTION
                          LOGIC .............................................101
           10. 00025649 5764- NEW PATIENT STATUS DISCHARGE CODE 70 .........112
           11. 00025651 5777- UPDATE POS CODE FOR TEMPORARY LODGING ........133
           12. 00025652 5768-IMPLEMENT MONTHLY BILL FOR RDF AND IUR ON OVERLAP
                          INPA ..............................................139
           13. 00025660 5790 CLINICAL TRIAL POLICY UPDATE ..................153
           14. 00025665 51#3 SETTING INCORRECTLY ON TOB 11X WHEN DETAIL
                          NONCOVERED ........................................164
           15. 00025668 5805-NEW MODIFIERS WHEN BILLING IN CLINICAL RESEARCH
                          STUDIES ...........................................169
           16. 00025675 5804 DME NCB ADDENDUM TO PHASE V FOR
                          PHYSICIANS/PRACTITIONER ...........................183
           17. 00025694 5779-NATIONAL COMPETITIVE BIDDING (NCB) PHASE V ....187
           18. 00025699 DOCUMENTATION CHANGES FOR RELEASE R2008200 .........201
           19. 00025700 R2008200 INSTALLATION INSTRUCTION - ONE-TIMER CONTROL CR
                           ..................................................205
           20. 00025701 EXTERNAL COPYBOOK CHANGES FOR R2008200 .............212
           21. 00025702 ARCHIVE MAINTENANCE FOR RELEASE R2008200 ...........216
           22. 00025718 5812 INCLUDE NPI FOR MBD/NGD EXTRACTS FROM CWF ON HOSP &
                          HH ................................................219
           23. 00025786 5900 NEW K CODE FOR REPLACEMENT INTERFACE MATERIAL .233
           24. 00025819 5913 NEW WAIVED TESTS ..............................239
           25. 00025831 5977 TYPE OF SERVICE (TOS) CORRECTIONS .............242
           26. 00025838 5980 APRIL UPDATES TO THE 2008 MPFSBD ..............243
           27. 00025841 5981 NEW HCPCS CODES FOR APRIL 2008 UPDATE .........253


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2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
                                                                        Page v
______________________________________________________________________________


      C.        ANALYSIS CHANGE REQUESTS........................................257
           1.     00024814 5030-ANALYSIS ONLY PROCESSING DX CDS FOR DME MACS ..257

APPENDIX A:       INSTALLATION INSTRUCTIONS ....................................260

APPENDIX B:       CICS TABLE UPDATES ...........................................283

APPENDIX C:       SOFTWARE RELEASE FILES .......................................284

APPENDIX D:      CUSTOMER REQUEST/ELEMENT CROSS-REFERENCE REPORT ..............289
                 ELEMENT/CUSTOMER REQUEST CROSS-REFERENCE REPORT ..............296




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section I. Release Overview                                             Page 1
______________________________________________________________________________

I.   RELEASE OVERVIEW

     The Host Quarterly Release is being NDMd today, March 4, 2008, and is
     scheduled to go into production on April 7, 2008.

A.   RELEASE DOCUMENT STRUCTURE

     SECTION I, RELEASE OVERVIEW - contains information describing the
     structure of this document, and distinguishes the sections that are
     included in the Final Release version from those included in the Pre
     Release versions. It also includes CWF Systems Documentation changes,
     Change Requests that were closed, or re-assigned, after being assigned to
     the Release, a list of changes that are cross-referenced to CRs that were
     developed for this Release, and changes that were made to the Release
     inventory. This section is started for the Pre Release Document, but is
     not completed until the Final Release Document.

     SECTION II, SPECIAL INFORMATION - includes changes that have been made to
     the CWF Systems Documentation, CWF modifications to HIMR, a list of
     changes requiring Satellite System Modifications, and a list of new,
     modified, and deleted edits related to the Change Requests within the
     Release. This section is started for the Pre Release Document, but is
     not completed until the Final Release Document.

     SECTION III, TECHNICAL INFORMATION - provides specific Impact Test
     results, which are provided by the CWF Beta Site. If available, the
     results will be included in the Host Release Document. However, if it is
     not available at the time the Host Release is sent, it will be sent in a
     separate letter. This section also contains elements that were added, or
     archived, for the Release.

     SECTION IV, PRE-PRODUCTION ACTIVITY - provides a high-level summary of
     steps that should be taken to verify the installation of the Release
     software in the Test region. Further detail is located in SECTION VI.
     The SPECIAL NOTES section contains technical information that is unique
     to the installation, and testing, of this Release. This section is
     started for the Pre Release Document, but is not completed until the
     Final Release Document.

     SECTION V, CONNECT:DIRECT CONTENTS - FILE STATISTICS - groups the
     datasets, including file statistics, that are included in the Host
     Release delivery. Chapter INSTALL of the CWF Systems Documentation
     contains a full description of the contents of the shipment, and the
     instructions for installing the CWF software. This section is provided
     with the Beta, Host, and Final Release Documents.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section I. Release Overview                                             Page 2
______________________________________________________________________________

    SECTION VI, TESTING DATA IN CURRENT RELEASE - provides information that is
    used by the Host Sites to verify the installation of the Release, along
    with the information required to duplicate the CWFM environment. This
    section is updated when CWFM sends input transactions, and response files,
    for Host Sites to use to verify the installation of the Host Release
    software.

    SECTION VII, DETAILED DESCRIPTION OF CHANGES - includes detailed
    descriptions of each Change Request. It is divided into three sections:
    one is specific to Host Site changes, another is specific to Satellite
    Site changes, and the last is specific to Analysis CRs that are in RESE
    (research) status.

    APPENDIX A, INSTALLATION INSTRUCTIONS - provides all of the necessary
    Installation Instructions for the Release. This section is not completed
    until the Final Release Document.

    APPENDIX B, CICS TABLE UPDATES - includes a complete listing of CICS Table
    updates for the current Release. This Appendix is under development
    throughout the Release, and the first version will not be included until
    the Beta version of the Release Document.

    APPENDIX C, SOFTWARE RELEASE FILES - lists the Software Release files that
    relate to this Release. This Appendix is under development throughout the
    system test period. The first version is available for the Beta Release
    Document.

    APPENDIX D, CUSTOMER REQUEST CROSS-REFERENCE REPORT - contains a Customer
    Request/Element Cross-Reference list. The Appendix shows the information
    in two different formats for easy use. The first lists the information by
    CR number, the second lists the information by element name. This
    Appendix is under development throughout the system test period. The
    first version will be available for the Beta Release Document.

    Additional appendices are present if documentation associated with a
    Release-specific CR is included with the Release Document. Further
    explanation of the content of these appendices can be found in the SPECIAL
    NOTES section of the Release Memo in Section IV, Part C.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section I. Release Overview                                             Page 3
______________________________________________________________________________

B.   DOCUMENTATION UPDATES AND REVISIONS

CWF Systems Documentation changes result from system changes occurring because
of the Change Requests included with the Release. The Release production date
is placed in the header at the top of each page. If using the mainframe
version of the documentation, changes are noted with a carat in the left
margin; if using the web site (http://cwf.2020llc.com/cwf), changes are noted
in red. The reason for each documentation change is indicated in the CWF
SYSTEMS DOCUMENTATION AFFECTED sub-section of the CR, or in the Documentation
only CR. A copy of the updated CWF Systems Documentation is provided with the
Host Quarterly Release and Final Quarterly Release.

The CWF Systems Documentation is available via the web site, as well as, via a
Connect:Direct transmission. The complete CWF Systems Documentation is
included in both deliveries. In the Connect:Direct version, the documentation
is located in the library entitled DOCUMENT, and this library is divided into
two members as follows:

*     DOCUMENT -   This member contains all CWF Systems Documentation volumes.
                   It can be used to print/search all documentation at one time.

*     PRODDOCO -   This member contains the CWF Systems Documentation as it
                   existed prior to the promotion of the current Release into
                   production.

The DOCUMENT library contains all of the individual files that make up the CWF
Systems Documentation. The files are used to search/print specific volumes of
the CWF Systems Documentation. The following chart describes the different
documentation sections:




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section I. Release Overview                                             Page 4
______________________________________________________________________________

MEMBER            CONTENT
___________________________________________________________________________

OVERCWF           Overview of the CWF System - General Information Manual:
                  Medicare; CWF History; CMS

OVERELGA          Overview of the Part A Eligibility System

OVERELGB          Overview of the Part B Eligibility System

OVERHIHO          Overview of the HIHO System - HIHO Training Manual

OVERHIMR          Overview of the HIMR System

OVERINFO          Overview of the INFOMAN Change Control System

ACRONYMS          List of Acronyms and Abbreviations Used Throughout the
                  Documentation

COPYINPR          Inter-program Communications Copybooks

COPYINTL          CWF Internal Record Specifications

COPYXTNL          CWF External Record Specifications

CWFMACRO          CWF Macro Specifications

DATAFLOW          Data Flow and Storage Manual

DATAMODL          Entity Relationship Model Diagram, Conceptual Data Model
                  Diagram

DESCLVL1          CWF Software Data

DESCLVL2          CWF Data Maintenance

DESCLV3B          Satellite Data

DISPCODE          CWF Disposition Codes

EDITABX           CWF A/B Crossover Edits

EDITALRT          CWF Alert Edits

EDITCONS          CWF Consistency Edits

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section I. Release Overview                                             Page 5
______________________________________________________________________________

MEMBER            CONTENT
___________________________________________________________________________

EDITLIST          Listing of CWF Edits

EDITMNTS          CWF Maintenance Edits

EDITUTIL          CWF Utilization Edits

HCPCS             HCPCS-By-Category Report

HIMRNAV           HIMR Navigational Document

HIMRPROM          HIMR Screen Prompts

HOSTJCL           Procedures

INSTALL           Procedures for Installation of CWF Software

LAYBENE           Beneficiary Database File Layouts

LAYSUPP           CWF Support File Layouts

PROGDTL           Computer Programming Detail

PURGE             Purge Record Formats

REPTPROD          Production Reports by Job name

SCRHOST           Host Screen Transactions

SYSDEF            Glossary of Terms; Definitions

TABLECO           Table of Codes

TBLEMANT          Overview and Process Descriptions

TRANSCLM          CMS Claim Transactions

TRANSINT          CWF Internal Transactions; Record Layouts

TRANSMNT          CMS Maintenance Record Layouts

XREF              XREF II Processing Information


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section I. Release Overview                                             Page 6
______________________________________________________________________________

C.   NSC (NO SYSTEM CHANGES) CHANGE REQUESTS

The Change Requests listed in this section were assigned to this Release.
During requirements gathering, they were changed to an NSC status. Refer to
INFOMAN for more detailed closure information.

     CR
     Number       Description
     ______       ___________

     None to report




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section I. Release Overview                                             Page 7
______________________________________________________________________________

D.   RE-ASSIGNED CHANGE REQUESTS

The Change Requests listed here require further evaluation. They have been
removed from R2008200. Refer to INFOMAN for up-to-date, re-assignment
information.

     CR
     Number       Description
     ______       ___________

     00024543     UR5601 SHOULD BE BYPASSED AS WERE 7270/7271 FOR CR3389

     00024919     HICR RECORDS WRITTEN AT FIXED MAXIMUM LENGTH

     00025100     POSTING SMOK PERIODS AND SESSIONS INCORRECTLY

     00025518     IME/GME CLAIM RECEIVING UR 5600 INCORRECTLY

     00025571     ALLOW ALL PCHL RECORDS TO BE DISPLAYED ON HIMR

     00025604     UR538N BYPASSED INCORRECTLY ON PART B ADJUSTMENTS

     00025618     EDIT 5237 FOR PARTB/DME IS NOT SETTING CORRECTLY FOR
                  CHOICES

     00025650     5767- MEDICARE ACUTE CARE EPISODE (ACE) DEMONSTRATION

     00025654     5783-NEW INPATIENT SPELL & ADJUSTMENT PROCESS FOR VA
                  CLAIMS

     00025664     HOME HEALTH CLAIM SHOULD SET 538F BUT SETTING 538I IN
                  ERROR

     00025710     5819-MODIFY CWF FEED TO LIMIT AMOUNT OF PREVENTATIVE DATA

     00025711     5821-MODIFY CWF FEED TO REMOVE UNNECESSARY DEFAULT NEXT
                  DATE

     00025713     5828-CREATE USER ACCOUNT FOR NEXT GENERATION DESKTOP ON
                  CWF




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section I. Release Overview                                             Page 8
______________________________________________________________________________

E.   COMBINED CHANGE REQUESTS

Change Requests that are being developed under other CRs are in COMB
(Combined) status. The CRs listed in the left column contain all of the
information, and will appear in SECTION VII, DETAILED DESCRIPTION OF
CHANGES. The CRs in COMB status will only be mentioned here.

      CR
      NUMBER      ORIGIN        DESCRIPTION
      ______      ______        ___________

      None to report




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section II. Special Information                                         Page 9
______________________________________________________________________________

II.   SPECIAL INFORMATION

A.    CWF SYSTEMS DOCUMENTATION CHANGES

The web address for the CWF Documentation website has been changed as a result
of the transition to the 2020 Company, LLC as the maintainer of the Common
Working File. The new web address is as follows:

              http://cwf.2020llc.com/cwf




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section II. Special Information                                        Page 10
______________________________________________________________________________

B.      CHANGES REQUIRING SATELLITE SYSTEM MODIFICATIONS

Each CR that contains Satellite Systems Modifications is specified below,
followed by the name of the record layout that is being modified. Please
refer to CR 00025701 for the specific updates.

00025598       5699 - REPORTING OF HEMATOCRIT AND HEMOGLOBIN TEST RESULTS

     Copybook Name: CABEHUBC
     Copybook Name: CABEHIBC


00025648       5766 - MODIFICATIONS TO THE CWF COBA CLAIMS SELECTION LOGIC

     Copybook Name: CABECOIF


00025660       5790 CLINICAL TRIAL POLICY UPDATE

     Copybook Name: CABEHUBC
     Copybook Name: CABEHIBC


00025694       5779-NATIONAL COMPETITIVE BIDDING (NCB) PHASE V

     Copybook Name: CABEHUBC
     Copybook Name: CABEHIBC
     Copybook Name: CABEHUCM




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section II. Special Information                                        Page 11
______________________________________________________________________________

C.   EDIT MODIFICATIONS BY CHANGE REQUEST

   1. 00025445 PART A ADJUSTMENTS ON ADD    HISTORY EDITS IN ERROR ON TRNG AUX
   IMPACT:
 (X) Host
 (X) Satellite Part A Outpatient
 a. Error Code: 538L ( )New (X)Modified     (   )Deleted
 b. Error Code: 538M ( )New (X)Modified     (   )Deleted
 c. Error Code: 538N ( )New (X)Modified     (   )Deleted
 d. Error Code: 538P ( )New (X)Modified     (   )Deleted
 e. Error Code: 539E ( )New (X)Modified     (   )Deleted
 f. Error Code: 538X ( )New (X)Modified     (   )Deleted


   2. 00025623 HCPCS G0141 SETTING 7172 INCORRECTLY WHEN MULT. DIAG ON CLM
   IMPACT:
 (X) Host
 (X) Satellite Part A Outpatient
 (X) Satellite Part B
 a. Error Code: 7172 ( )New (X)Modified ( )Deleted


   3. 00025640 5756 REVISION TO CR 4294 LOW VISION REHAB DEMO
   IMPACT:
 (X) Host
 (X) Satellite Part A Outpatient
 (X) Satellite Part B
 a. Error Code: 538X ( )New (X)Modified ( )Deleted (Pt. B Carrier)
 b. Error Code: 538X ( )New (X)Modified ( )Deleted (OUTP)
 c. Error Code: 538Y ( )New (X)Modified ( )Deleted (OUTP)
 d. Error Code: 538Y ( )New (X)Modified ( )Deleted (Pt. B Carrier)


   4. 00025641 5757- ADDL CWF EDITING FOR SNF CB PART II
   IMPACT:
 (X) Host
 (X) Satellite Part A Inpatient
 (X) Satellite Part B
 a. Error Code: 7258 ( )New (X)Modified ( )Deleted
 b. Error Code: 7259 ( )New (X)Modified ( )Deleted




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section II. Special Information                                        Page 12
______________________________________________________________________________

  5. 00025649 5764- NEW PATIENT STATUS DISCHARGE CODE 70
  IMPACT:
(X) Host
(X) Satellite Part A Inpatient
(X) Satellite Part A Outpatient
(X) Home Health
a. Error Code: 2101 ( )New (X)Modified ( )Deleted
b. Error Code: 7545 ( )New (X)Modified ( )Deleted
c. Error Code: 7272 ( )New (X)Modified ( )Deleted
d. Error Code: 729H ( )New (X)Modified ( )Deleted


  6. 00025651 5777- UPDATE POS CODE FOR    TEMPORARY LODGING
  IMPACT:
(X) Host
(X) Satellite Part B
(X) DMERC
a. Error Code: 77x1 ( )New (X)Modified    (   )Deleted
b. Error Code: C029 ( )New (X)Modified    (   )Deleted
c. Error Code: 77x3 ( )New (X)Modified    (   )Deleted
d. Error Code: 5507 ( )New (X)Modified    (   )Deleted


  7. 00025652 5768-IMPLEMENT MONTHLY BILL FOR RDF AND IUR ON OVERLAP INPA
  IMPACT:
(X) Host
(X) Satellite Part A Inpatient
(X) Satellite Part A Outpatient
a. Error Code: 729I ( )New (X)Modified ( )Deleted


  8. 00025665 51#3 SETTING INCORRECTLY ON TOB 11X WHEN DETAIL NONCOVERED
  IMPACT:
(X) Satellite Part A Inpatient
(X) Satellite Part A Outpatient
a. Error Code: 51#3 ( )New (X)Modified ( )Deleted


   9. 00025668 5805-NEW MODIFIERS WHEN BILLING IN CLINICAL RESEARCH STUDIES
   IMPACT:
 (X) Host
 (X) Satellite Part B
 (X) DMERC
 a. Error Code: 5232 ( )New (X)Modified ( )Deleted (Pt. B Carrier)
 b. Error Code: 5232 ( )New (X)Modified ( )Deleted (DMEPOS)
 c. Error Code: 5270 ( )New (X)Modified ( )Deleted (Pt. B Carrier)
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section II. Special Information                                        Page 13
______________________________________________________________________________

 d.   Error Code:   5270   ( )New (X)Modified ( )Deleted   (DMEPOS)


   10. 00025675 5804 DME NCB ADDENDUM TO PHASE V FOR PHYSICIANS/PRACTITIONER
   IMPACT:
 (X) Host
 (X) DMERC
 a. Error Code: 7552 (X)New ( )Modified ( )Deleted


   11. 00025694 5779-NATIONAL COMPETITIVE BIDDING (NCB) PHASE V
   IMPACT:
 (X) Host
 (X) DMERC
 a. Error Code: C022 ( )New (X)Modified ( )Deleted
 b. Error Code: D903 ( )New (X)Modified ( )Deleted


   12. 00025786 5900 NEW K CODE FOR REPLACEMENT INTERFACE MATERIAL
   IMPACT:
 (X) Host
 (X) Satellite Part A Outpatient
 (X) Home Health
 (X) DMERC
 a. Error Code: 6912 ( )New (X)Modified ( )Deleted


   13. 00025841 5981 NEW HCPCS CODES FOR APRIL 2008 UPDATE
   IMPACT:
 (X) Host
 (X) Satellite Part A Inpatient
 (X) Satellite Part A Outpatient
 (X) DMERC
 a. Error Code: 51#G ( )New (X)Modified ( )Deleted




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section II. Special Information                                        Page 14
______________________________________________________________________________

D.   SYSTEMS MODIFICATIONS TO HIMR

These are the System Modifications to HIMR for CR 00025598:

 Requirement 4
 Create two new fields in the detail line level for the HIMR
 screens for PTBH and DMEH. First field will be a 2-byte
 alpha-numeric field for Test Type and the second will be a
 3-byte numeric field for Test Results (decimal implied xx.x).
 (CICSMAPS HMRMPB4 & HMRMDE4)

 (CICSMAPS HMRMPB4)

 NPI RENDER UPIN            PRESCRIPTION NUM
 ICN                 LINE__ OF     ENTRY CD  CLM FROM          CLM THRU
 FROM DTE THRU DTE PLACE TOS HCPCS      MOD      UNITS MTU/IND SUB CHG

 SPECIALTY PRICING IND        DIAG CD              CARRIER              CMS
 TOTAL PAT REIMB              PROV TAX NUMBER                     PROV IND
 TOTAL PROV REIMB             PROV AREA ==>TT XX ==>TR 00.0 PROV TYPE
 CASH DED APPLIED             PROV SPEC CODE                        PROV SPE
 CO INS                       PHYS: SUP NO           PROV NO
 CLINICAL LAB AMT                    ZIP CODE              UPIN      DOC IND
 CLINICAL LAB ID              PCT ALLOWED        HP/SC IND    ANESTHESIA
 MSP APPLIED                MSP        POP ZIP         TYPE SERVICE   ACT CD
 OTHER AMTS APPLIED 1:           2:           3:           4:          5:
 OTHER AMTS IND     1:           2:           3:           4:          5:
 DME RNT/COVDT            PURCHASE          NECESSARY      SUSP DUP REV IND
 CMS: ASSIGNMENT     PAY PROCESS      REIMB            DED       PAY SCREEN
 OVERRIDE EDIT1:       EDIT2:       EDIT3:        EDIT4:      EDIT5:




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section II. Special Information                                        Page 15
______________________________________________________________________________

(CICSMAP HMRMDE4)

DMEH                          DMEPOS CLAIM HISTORY                  PAGE    3

ICN 25073-1.1.1-4     LINE01 OF 01 ENTRY CD 1 CLM FROM 08/05/05 CLM THRU 0
FROM/THRU PL/TOS HCPCS MOD        DIAG ITEMS UNITS/IND            SUB/ALLOW CHG
08/05/05    12     K0002 RR KJ 7812 001                1.000          88.00
08/05/05    R                                        3                81.83
SPECIALTY PRICING IND D NPI SUPP                  SUPPLIER          4779300004
TOTAL PAT REIMB           ==>TT XX       ==>TR 00.0          SUPP TAX NUBER
TOTAL SUPP REIMB      65.46                       SUPPLIER TYPE     3
CASH DED APPLIED                                  SUPP SPECIALTY 54
CO INS                16.37 SUSP DUP REV IND      SUPPLIER STATE KS
SCREEN SUS IND 1511 SCREEN RES IND E SCREEN SVGS                    DECISION IN
NDC               NOC DESC                     RES STATE KS DME PURCHASE
MSP APPLIED      0.00    MS    WAIVER N ACT CODE SW      DOC IND 1 NCBIND Y
OTHER AMTS APPLIED 1:             2:        3:            4:            5:
OTHER AMTS IND      1: N          2: N      3: N          4: N          5: N
CMS: ASSIGNMENT 3 PAY PROCESS A        REIMB 0 DED 0 PAY SCREEN 9
OVERRIDE EDIT1:         EDIT2:       EDIT3:        EDIT4:        EDIT5:




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section II. Special Information                                        Page 16
______________________________________________________________________________


These are the System Modifications to HIMR for CR 00025640:

Requirement 2
Modify the HIMR VISN Screen to allow the display of multiple
years. The Initial HIMR display will show the Pre 04/01/2008
VISN information if available, with the option of entering
a specific post 04/01/2008 year for review.

VISN            LOW VISION DEMONSTRATION              PAGE     1 OF 1
HIC 012345678A          LOCAL HOST              DOB 01/01/1901    SEX
CORR 012345678A      NAME HENRY.HENRY.H,        DOD               SOURCE
VSN 1
          INP 0000 OUT 0000 HOS 0000 PTB 0000 DME 0000 HHA 0000 BLK N
DISPLAY CAL YR: XXXX    <<<<<<< New Enterable Field
INITIAL DATE    06/22/2005               ACCUMULATED TIME    405
90-DAY DATE     09/20/2005

      FROM       THRU                CLAIM
HCPCS DATE       DATE       TIME     TYPE TOS      ICN/DCN
G9041 06/22/2005 06/22/2005 405      B     Q       25640-1


F2=MENU F3=RETURN F4=BENA F5=BENB F7=BWD F8=FWD F12=EXIT

Note:   Due to SATELLITE/HOST processing limitations, this will
        be the initial screen for ALL VISN requests in HIMR.

        In the case where only post 1 Apr 2008 data is available
        for a beneficiary, this screen will show the 'YEAR' in
        the DISPLAY CAL YR: field and the Initial Date and
        90-DAY DATE will be blanked out. The earliest record
        available on the file will be displayed.

        The screen below in Requirement 3 will be displayed only
        if a valid year is input for and requested.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section II. Special Information                                        Page 17
______________________________________________________________________________

Requirement 3
If a valid year is keyed into the DISPLAY CAL YR: field, the
VISN Calendar year information shall be displayed if available.
The INITIAL DATE and 90-DAY DATE will be removed from the display
since they are not applicable to the new requirements.


VISN            LOW VISION DEMONSTRATION              PAGE     1 OF 1
HIC 012345678A          LOCAL HOST              DOB 01/01/1901    SEX
CORR 012345678A      NAME HENRY.HENRY.H,        DOD               SOURCE
VSN 1
          INP 0000 OUT 0000 HOS 0000 PTB 0000 DME 0000 HHA 0000 BLK N
DISPLAY CAL YR: 2008    <<<<<<< New Enterable Field
                                         ACCUMULATED TIME    405




      FROM       THRU                CLAIM
HCPCS DATE       DATE       TIME     TYPE TOS      ICN/DCN
G9041 06/22/2008 06/22/2008 405      B     Q       25640-2




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section II. Special Information                                        Page 18
______________________________________________________________________________

These are the System Modifications to HIMR for CR 00025648:

 Requirement 10
 CWF must modify the 'COBS' screen in HIMR to display the new
 exclusion for 'ADJUSTMENTS'. The valid value will be a 'Y'.

 COBA                         COBA INSURANCE FILE - INQUIRY
 11/01/2007                                                      PAGE
  COBA ID:                     TIN:                              FILE MAINT DATE:
    NAME:
    ADDR1:
    ADDR2:
    CITY:                                    STATE:       ZIP:

 COMMON CLAIM EXCLUSIONS = Y      MASS ADJ: MPFS       OTHER
 NON ASSIGNED:    ORIG EQ100:     ORIG GT100:     DENIED NO LIA:    DENIED
      ADJ MON:    ADJ NONMON:            MSP:         OTHER INS:         NC
      ADJ 100% PAID:                     ADJ 100% DENIED NO ADDTL LIAB:
      ADJ 100% DENIED ADDTL LIAB:        MSP COST AVOIDS:
 ALL CLAIM EXCLUSIONS: PART-A:     PART-B:    DMERC:   ADJUSTMENTS: <<<<
 BILL TYPE EXCLUSIONS:

 11   HOSP INPA     :    12   HOSP INPB :     13   HOSP OUTP     :   14   HOSP OTHER
 18   HOSP SWING    :    21   SNF INPA   :    22   SNF INPB      :   23   SNF OUTP
 24   SNF OTHER B   :    28   SNF SWING :     32   HH PARTB      :   33   HH PARTA
 34   HH OUTP       :    41   REL NON MED:    71   CL RURAL      :   72   CL FREESTA
 73   CL FED HC     :    74   CL OUTP R :     75   CL CORF       :   76   CL COMP MH
 79   CL OTHER      :    81   HOSP NONH :     82   HOSP H        :   83   AMB SURG C
 85   PRI CARE H    :

      CLEAR=EXIT    PF3=RETURN    ENTER=PROCESS    PF8=FWRD

 Requirement 11
 CWF must ensure the new 'AC' Crossover Disposition Indicator
 is displayed on the detail of Page 3 of the INPH, OUTH, HHAH
 and HOSH for Part A records in HIMR.

 Requirement 12
 CWF must ensure the new 'AC' Crossover Disposition Indicator
 is displayed on the detail of Page 2 of the PTBH and DMEH
 record in HIMR.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section II. Special Information                                        Page 19
______________________________________________________________________________

 Requirement 13 (Internal to CWF only)
 The COIF Update Screen (HCOI) in HIMR must be modified
 to include an entry for 'ADJUSTMENTS'.

 HCOI HCOICOIF        COBA INSURANCE FILE -       INQUIRY MODE
 11/01/2007                                                 PAGE
  COBA ID: 0000000000   TIN:                                FILE MAINT DATE:
    NAME :
    ADDR1:
    ADDR2:
    CITY:                             STATE:           ZIP:     -

 COMMON CLAIM EXCLUSIONS = Y       MASS ADJ: MPFS       OTHER
 NON ASSIGNED:     ORIG EQ100:     ORIG GT100:    DENIED NO LIA:     DENIED
      ADJ MON:     ADJ NONMON:            MSP:         OTHER INS:         NC
      ADJ 100% PAID:                      ADJ 100% DENIED NO ADDTL LIAB:
      ADJ 100% DENIED ADDTL LIAB:         MSP COST AVOIDS:
 ALL CLAIM EXCLUSIONS: PART A: PART B: DMERC:         ADJUSTMENTS: <<<<<
 BILL TYPE EXCLUSIONS:
   11 HOSP INPA :      12 HOSP INPB :      13 HOSP OUTP :     14 HOSP OTHER
   18 HOSP SWING :     21 SNF INPA    :    22 SNF INPB :      23 SNF OUTP
   24 SNF OTHER B:     28 SNF SWING :      32 HH PARTB :      33 HH PARTA
   34 HH OUTP    :     41 REL NON MED:     71 CL RURAL :      72 CL FREESTAN
   73 CL FED HC :      74 CL OUTP R :      75 CL CORF    :    76 CL COMP MH
   79 CL OTHER   :     81 HOSP NONH :      82 HOSP H     :    83 AMB SURG CT
   85 PRI CARE H :

  CLEAR=EXIT   PF3=RETURN   ENTER=PROCESS   PF8=FWRD




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section II. Special Information                                        Page 20
______________________________________________________________________________

These are the System Modifications to HIMR for CR 00025660:

Requirement 5
CWF must create and display a new eight-byte field in the
header of the PTBH screen for Part B records in HIMR. The
new field will contain the 'Clinical Trial Number'.

Note: The BLD DED has been moved over to place the CT NUM
      between the BLD DED and MSP FLAG.

PTBH                            PART B CLAIM HISTORY                    PAGE     1
HIC                                   LOCAL HOST                  DOB
CORR                   NAME                                       DOD                S
BOI 1 MSP 3 REP 2
                       INP 0000 OUT 0000 HOS 0000 PTB 0002 DME 0000 HHA 000
NPI REF PHY                NPI CPO               REFER PHYS                    UPIN
ICN                    NUM-LINES       ENTRY CD     CLM FROM            CLM THRU 1
CARRIER                SURNAME APPLE FI M DOB                  SEX      ASSIGNMENT
                       EXCP/NONEXCP IND      SITE OF SERVICE
CLAIM REIM                       BLD DED 00 CT NUM xxxxxxxx <<<<< MSP FLAG
AMT PAID BY BENE                 PAY DENIAL IND                           MSP AMT
DED MED                          PAY DENIAL DTE                           ACCIDENT
CASH DED                         CLAIM RECEIPT DTE                        PAT REL
CO INS                           CPT INTEREST               UNSOL IND     LIAB IND
DED PSYC                         COMP CARRIER               SANC PROV     WORK RELA
DED PTHPY                        COMP ID NUM                              SIGNATURE
DED OTHPY                        COMP IND               DOA               CANC
DG1        DG2         DG3         DG4         DG5        DG6         DG7         DG
CLEAN CLM      SPLIT       ADJ: MASS     CLM       BENE DIED       PRIVACY     MICR
REP PAYEE      SRCE      AUTO ADJ       IND3            IND4       IND5        HCPC
REMARKS:                   SUBMITTER 12599               DEMO NUM              EXAM
OVERRIDE EDIT1:          EDIT2:         EDIT3:        EDIT4:        EDIT5:



     F2=MENU F3=RETURN F4=BENA F5=BENB F7=BWD F8=FWD F12=EXIT




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section II. Special Information                                        Page 21
______________________________________________________________________________

 Requirement 6
 CWF must create and display a new eight-byte field in the
 header of the DMEH screen for DMERC records in HIMR. The
 new field will contain the 'Clinical Trial Number'.

 DMEH                          DMEPOS CLAIM HISTORY                PAGE     1
 HIC                                 LOCAL HOST               DOB
 CORR                 NAME                                    DOD
 CMN 1 HOS 1 MSP 1 REP 2 SUR 1
                  INP 0001 OUT 0001 HOS 0001 PTB 0001 DME 0001 HHA 000
 NPI HEADER
 ICN DISP             NUM-LINES     ENTRY CD    CLM FROM           CLM THRU
 DMERC                SURNAME APPLE FI M DOB              SEX M    ASSIGNMENT
 IDE NUMBER:                                   ADJ: MASS   CLM
 CLAIM REIM                                                         MSP FLAG
 AMT PAID BY BENE               PAY DENIAL IND                      MSP AMT
 DED MED                        PAY DENIAL DTE                      ACCIDENT
 CASH DED                       CLAIM RECEIPT DTE                   PAT REL
 CO INS                         CPT INTEREST                        SANC-IND
 UNSOL IND    IHS IND           COMP CARRIER                        WORK RELA
 CT NUM xxxxxxxx <<<<<<<        COMP ID NUM                         SIGNATURE
 LIAB IND      NCPDP IND        COMP IND            DOA             CANC
                      REFER UPIN          DIAG CD: PRI        SEC1       SEC2
 CLEAN CLM    SPLIT                            BENE DIED      PRIVACY    MICR
 REP PAYEE    SRCE      AUTO ADJ     IND3           IND4      IND5       HCPC
 REMARKS:                SUBMITTER                   DEMO NUM            EXAM
 OVERRIDE EDIT1:        EDIT2:       EDIT3:       EDIT4:       EDIT5:

         F2=MENU F3=RETURN F4=BENA F5=BENB F7=BWD F8=FWD F12=EXIT




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section II. Special Information                                        Page 22
______________________________________________________________________________

These are the System Modifications to HIMR for CR 00025694:

 Requirement 6
 CWF will add the new National Competitive Billing (NCB)
 indicator field to the line level DMEH HIMR screen (CICSMAP HMRMDE4).

 DMEH                         DMEPOS CLAIM HISTORY                 PAGE    3

 ICN 25073-1.1.1-4     LINE01 OF 01 ENTRY CD 1 CLM FROM 08/05/05 CLM THRU 0
 FROM/THRU PL/TOS HCPCS MOD        DIAG ITEMS UNITS/IND          SUB/ALLOW CHG
 08/05/05    12     K0002 RR KJ 7812 001               1.000        88.00
 08/05/05    R                                        3              81.83
 SPECIALTY PRICING IND D NPI SUPP                  SUPPLIER        4779300004
 TOTAL PAT REIMB              TT        TR         SUPP TAX NUMBER 4319877173
 TOTAL SUPP REIMB      65.46                       SUPPLIER TYPE   3
 CASH DED APPLIED                                  SUPP SPECIALTY 54
 CO INS                16.37 SUSP DUP REV IND      SUPPLIER STATE KS
 SCREEN SUS IND 1511 SCREEN RES IND E SCREEN SVGS                  DECISION IN
 NDC               NOC DESC                     RES STATE KS DME PURCHASE
 MSP APPLIED      0.00    MS    WAIVER N ACT CODE SW     DOC IND 1 NCBIND Y<==
 OTHER AMTS APPLIED 1:             2:        3:            4:          5:
 OTHER AMTS IND      1: N          2: N      3: N          4: N        5: N
 CMS: ASSIGNMENT 3 PAY PROCESS A        REIMB 0 DED 0 PAY SCREEN 9
 OVERRIDE EDIT1:         EDIT2:       EDIT3:        EDIT4:      EDIT5:




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section II. Special Information                                        Page 23
______________________________________________________________________________

 Requirement 7
 CWF will add the new National Competitive Billing (NCB)
 indicator field to the detail in the CMNAUX HIMR screen
 (CICSMAP HMRMCN2).

 CMND                              CMN DETAIL                    PAGE    1
 HIC 725694100A                     LOCAL HOST              DOB 11/10/1920
 CORR 725694100A     NAME                                   DOD            S
 CMN 3
                     INP 0000 OUT 0000 HOS 0000 PTB 0000 DME 0000 HHA 000

 HCPCS A5500 INIT CERT DT 120101 END DT 120102 ST        CAT 9 SKLTN
 CARRIER 00885 DT CREATED 112807 DT UPDATED            SUB HCPCS _____
 CUM MN 12 REC/REV 00 USEFUL LIFE            MAINT DATE          RNT SRV
 PUR: DEC    DT         AMT      0.00 RNT: SUP               AMT         0.
 NXT SCH RC          DIAG 41409                     LST SEEN          MN
 ORD UPIN A12345   ORD NAME B CASEY          SUP NO 998877       PTRS 12
 DELIVERY DT 010100 REPLACE _ WARRANTY: IND N LEN 00 TYP _
 NPI ORD PHY UPIN            NPI SUPPLIER         ==> NCBIND <==
 RC/RV DT         TYPE __ ST _ NPI OPU __________ NPI SUPP __________
 CARRIER _____ DT CREATED           DT UPDATED         DISCONTINUE DATE
 NXT SCH RC          DIAG _____ _____ _____ _____ LST SEEN            MN
 ORD UPIN ______   ORD NAME _ _____________ SUP NO __________ PTRS __
 RC/RV DT         TYPE __ ST _ NPI OPU __________ NPI SUPP __________
 CARRIER _____ DT CREATED           DT UPDATED         DISCONTINUE DATE
 NXT SCH RC          DIAG _____ _____ _____ _____ LST SEEN            MN
  ORD UPIN ______   ORD NAME _ _____________ SUP NO __________ PTRS __




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section II. Special Information                                        Page 24
______________________________________________________________________________

These are the System Modifications to HIMR for CR 00025718:

 Requirement 1
 CWF already carries the four new fields (10 bytes) for
 the NPI that coincides with the legacy Provider Numbers
 in the Hospice Period on the physical record for the
 Hospice Auxiliary File. However, CWF will need to add
 the four new fields (10 bytes) to the Hospice Periods
 on the HOSP Auxiliary File (HOSP) in HIMR.

 If the NOE or Hospice record is accepted in CWF and the
 NPI for the legacy Provider Number is present, CWF
 will populate the NPI also in the Hospice Period.
 The Hospice Period on the Hospice Auxiliary File (HOSP)
 carries the following legacy Provider Numbers:

 a)   Prov 1
 b)   Prov 2
 c)   Change of Ownership Prov 1
 d)   Change of Ownership Prov 2

 CWF will not validate the NPI and continue to use the
 legacy Provider Number for processing Hospice.

 No modification is required to Trailer '02' to carry the NPI.

 No modification is required to the Provider Inquiry screens
 HIQA, HIQH, or HUQA to carry the NPI. This is not necessary
 since the screens will be obsolete in the near future.

 If an adjustment (Action Code 3) is accepted in CWF,
 with a different NPI than the one posted on the
 HOSP Auxiliary File, CWF will overlay the NPI.

 If a cancel (Action Code 4) is accepted in CWF and
 does not remove the Hospice Period, CWF should not
 update the NPI in the Period.

 If TOB '8xB' to revoke a Hospice Period is accepted and the
 NPI is different than the NPI in the Hospice Period, CWF will
 overlay the NPI from the revoked NOE.

 If TOB '8xD' to cancel a Hospice Period is accepted
 and the NPI is different than the NPI in the
 Hospice Period, CWF will cancel the Hospice Period
 and not match based on NPI.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section II. Special Information                                        Page 25
______________________________________________________________________________


 HIMR Screen Update for Hospice(HOSP) period:
 --------------------------------------------
                  PERIOD         OWNER CHANGE     PERIOD        OWNER CHA
 START DATE 1
 TERM DATE
 PROV 1
 NPI 1 =========> XXXXXXXXXX     XXXXXXXXXX
 INTER 1
 EARLIEST BILLING
 LATEST BILLING
 DAYS USED
 START DATE 2
 PROV 2
 NPI 2 =========> XXXXXXXXXX     XXXXXXXXXX
 INTER 2
 DIAG CD
 REVOCATION IND

 Requirement 3
 CWF will need to add one new field (10 bytes) to the
 Home Health Episode on the HH PPS Episode Auxiliary
 File (HHEH) in HIMR.

 HIMR Screen Update for Home Health Episode:
 -------------------------------------------
                     EPISODE             EPISODE             EPISODE
  START DATE
  END DATE
  CONTRACTOR
  PROVIDER
  NPI NUMBER ======> XXXXXXXXXX          XXXXXXXXXX          XXXXXXXXXX
  HRG CODE-DATE 1
  HRG CODE-DATE 2
  HRG CODE-DATE 3
  HRG CODE-DATE 4
  HRG CODE-DATE 5
  HRG CODE-DATE 6
  DOEBA - DOLBA
  PRIN/SECOND DIAG
  LUPA IND
  PATIENT STATUS
  CANCEL IND

 Note: Due to space problem on the screen, DOEBA and DOLBA will
       appear on the same line.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section III. Technical Information                                     Page 26
______________________________________________________________________________

III. TECHNICAL INFORMATION

A.   IMPACT TEST

     This section will be supplied by the STC Beta Site.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section III. Technical Information                                     Page 27
______________________________________________________________________________

B.   ADDED/ARCHIVED MODULES

     1.   ADDED ELEMENTS

          The following SOURCE modules are new to the CWF system:

          UTLS82A0
          UTLS82B0
          UTLS82C0


          The following PROC modules are new to the CWF system:

          UTLP82A0
          UTLP82B0
          UTLP82C0


          The following UTILITY modules are new to the CWF system:

          UTLJ82A0
          UTLJ82B0
          UTLJ82C0


     2.   ARCHIVED ELEMENTS

          Archive the following SOURCE modules:

         UTLS71A0
         UTLS71B0
         UTLS71C0
         UTLS71DA
         UTLS71D0
         UTLS71E0
         UTLS71E1
         UTLS71E2
         UTLS71E3
         UTLS71E4
         UTLS71F0
         UTLS71G0
         UTLS71G1
         UTLS71G2
         UTLS72A1
         UTLS72B0
         UTLS72C0
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section III. Technical Information                                     Page 28
______________________________________________________________________________

        UTLS73C0
        UTLS74A0


        Archive the following UTILITY modules:

        UTLJ71A0    UTLJ71GA
        UTLJ71B0    UTLJ71G0
        UTLJ71C0    UTLJ71G1
        UTLJ71DA    UTLJ71G2
        UTLJ71D0    UTLJ71G3
        UTLJ71D1    UTLJ71G4
        UTLJ71D2    UTLJ71G5
        UTLJ71D3    UTLJ71G6
        UTLJ71D4    UTLJ71G7
        UTLJ71D5    UTLJ71G8
        UTLJ71D6    UTLJ71G9
        UTLJ71D7    UTLJ72A1
        UTLJ71D8    UTLJ72B0
        UTLJ71D9    UTLJ72C0
        UTLJ71EA    UTLJ72C1
        UTLJ71EB    UTLJ72C2
        UTLJ71E0    UTLJ72C3
        UTLJ71E1    UTLJ72C4
        UTLJ71E2    UTLJ72C5
        UTLJ71E3    UTLJ72C6
        UTLJ71E4    UTLJ72C7
        UTLJ71E5    UTLJ72C8
        UTLJ71E6    UTLJ72C9
        UTLJ71E7    UTLJ73A0
        UTLJ71E8    UTLJ73B0
        UTLJ71E9    UTLJ73C0
        UTLJ71F0    UTLJ74A0


        Archive the following PROC modules:

         UTLP71A0   UTLP72A1
         UTLP71B0   UTLP72B0
         UTLP71C0   UTLP72C0
         UTLP71DA   UTLP73A0
         UTLP71D0   UTLP73B0
         UTLP71E0   UTLP73C0
         UTLP71E1   UTLP74A0
         UTLP71E2
         UTLP71F0
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section III. Technical Information                                     Page 29
______________________________________________________________________________

        UTLP71G0
        UTLP71G1


        Archive the following CONTROL CARD modules:

        UTLC71DA
        UTLC71E0
        UTLC71E1
        UTLC71G0
        UTLC72B0




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section IV. Pre-Production Activity                                    Page 30
______________________________________________________________________________

IV.    PRE-PRODUCTION ACTIVITY

A.     HOST PRE-PRODUCTION ACTIVITY

Host Sites should use the following procedure to verify the installation of
the Release software in the test region.

 1. Establish Test Region:
    a.   Perform INIT
         - Initialize test region

      b.   Run REGRLOAD
           - Load history claims, Beneficiary, and Auxiliary file

      c.   Run CABMNSCW utility
           - Load NSC file to establish DMEPOS Supplier Number Table

      d.   Run test cycles
           - Bring in benchmark input

      e.   Compare response file output




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section IV. Pre-Production Activity                                    Page 31
______________________________________________________________________________

B.   SPECIAL INSTALLATION INSTRUCTIONS

CR 00025700 is the installation instruction/one-timer control CR for this
release. This CR is used to document all the one-timers and installation
instructions for each CR in the release. The Instructions are not listed in
any particular order within this CR.

For the order in which the one-timers should be run, refer to Appendix A.
Appendix A is divided into eight sections: Host/Satl Pre-Pre Installation,
Host/Satl Pre-Installation, Host/Satl Installation, and Host/Satl Post-
Installation. These instructions should be performed in the order specified.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section IV. Pre-Production Activity                                    Page 32
______________________________________________________________________________

C.     SPECIAL NOTES

     1. The following CMS CRs will not be delivered at this time. It is
        anticipated that they will be delivered in the R20082AF Follow-Up
        Release on 03/07/2008:

       00025660 - 5790 CLINICAL TRIAL POLICY UPDATE
       00025694 _ 5779-NATIONAL COMPETITIVE BIDDING NCB) PHASE V

     2. The following CMS CRs are dependant upon the delivery of the two CRs
        cited above:

       00025641 - 5757-ADDL CWF EDITING FOR SNF CB PART II
       00025668 - 5805-NEW MODIFIERS WHEN BILLING IN CLINICAL RESEARCH STUDIES

     3. The Final PMs have not been received for the following CRs, so they can
        not be delivered:

       00025819   -   5913   NEW WAIVED TEST
       00025831   _   5977   TYPE OF SERVICE CORRRECTIONS
       00025838   _   5980   APRIL UPDATES TO 2008 MPFSBD
       00025841   _   5981   NEW HCPCS CODES FOR APRIL 2008 UPDATE

     4. CR 00025600 _ REWRITE ITF PROGRAM HIIDCCOP will not be delivered with
        the April release. It will be rescheduled for a later release.

     5. Production Problem 00025859 _ HIMR TRAINING SCREEN DISPLAYING BAD DATA
        is being delivered with this release. This delivery provides the extra
        testing this Problem needs.

     6. The CWF User Documentation updates are not completed for the following
        CRs. The updates will be included with the version of the Documentation
        sent with the Final Release:

       00025598   _   5699_REPORTING OF HEMATOCRIT AND HEMOGLOBIN TEST RESULTS
       00025660   _   5790-CLINICAL TRIAL POLICY UPDATE
       00025668   -   5805-NEW MODIFIERS WHEN BILLING IN CLINICAL RESEARCH STUDIES
       00025694   _   5779-NATIONAL COMPETITIVE BIDDING (NCB) PHASE V

     7. These CRs listed in Section VII.C. represent analysis-only efforts.
        There are no software deliverables for the April release with these CRs.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section V. Connect:Direct Contents - File Statistics                   Page 33
______________________________________________________________________________

V.      CONNECT:DIRECT CONTENTS - FILE STATISTICS

 The track estimate was based on 3390 DASD.

 Host files:
 -----------
                                      NO. OF                                 DIR
 FILE    DSName                       MEMBERS DSORG RECFM LRECL BLKSZE TRKS BLKS
 ____    _______________________      _______ _____ _____ _____ ______ ____ _____
  1.     *.RCCYYQST.H.SW.BTCH.LD        198     PO     U      0 23200 312     100
  2.     *.RCCYYQST.H.SW.CARTBL         N/A     PS    VB   7716 23476     1   N/A
  3.     *.RCCYYQST.H.SW.CICS.TAB       16      PO   FBA    133 23408    27     5
  4.     *.RCCYYQST.H.SW.CNTLCARD       120     PO    FB     80   6160    6    50
  5.     *.RCCYYQST.H.SW.COPYLIB        573     PO    FB     80   6160 151    200
  6.     *.RCCYYQST.H.SW.EDIT.TBL       N/A     PS    VB   4551 24498     2   N/A
  7.     *.RCCYYQST.H.SW.HCPCS          N/A     PS    VB    529 27598    48   N/A
  8.     *.RCCYYQST.H.SW.IDCMCARD       545     PO    FB     80   6160   25   100
  9.     *.RCCYYQST.H.SW.JCLLIB         138     PO    FB     80   6160    9    50
 10.     *.RCCYYQST.H.SW.ONL.LD         543     PO     U      0 23200 198     100
 11.     *.RCCYYQST.H.SW.PROCLIB        168     PO    FB     80   6160   27    50
 12.     *.RCCYYQST.H.SW.PROG.LST       723     PO   FBA    133 23408 4795    200
 13.     *.RCCYYQST.H.SW.RPT.TITLES     N/A     PS    FB     34   3400    1   N/A
 14.     *.RCCYYQST.H.SW.UTILLIB        198     PO    FB     80   6160   31    50
 15.     *.RCCYYQST.H.TD.BENEDATA       N/A     PS    VB 32004 32008     65   N/A
 16.     *.RCCYYQST.H.TD.BENES          4       PO    VB 13322 27998 128       10
 17.     *.RCCYYQST.H.TD.MISC           6       PO    VB 26142 27998 705       10
 18.     *.RCCYYQST.H.TD.SITE.CLM       3       PO    VB 19800 27998 2198      50
 19.     *.RCCYYQST.H.TD.SITE.RESP      3       PO    VB 26327 27998 251       10
 20.     *.RCCYYQST.H.TX.DOCUMENT       44      PO   FBA    110 27500 856      20
 21.     *.RCCYYQST.H.TX.RLSE.DOC       N/A     PS   FBA     90 27000    26   N/A

 Note:     Asterisk denotes prefix used at each Host site, RCCYYQST denotes the
            Release number of the current release.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section V. Connect:Direct Contents - File Statistics                   Page 34
______________________________________________________________________________

Satellite files:
----------------
                                    NO. OF                                 DIR
FILE    DSName                      MEMBERS DSORG RECFM LRECL BLKSZE TRKS BLKS
____    _______________________     _______ _____ _____ _____ ______ ____ _____
 1.     *.RCCYYQST.S.SW.BTCH.LD       14      PO     U     0   23200    6    50
 2.     *.RCCYYQST.S.SW.CARTBL        N/A     PS    VB 7716    23476    1    NA
 3.     *.RCCYYQST.S.SW.CICS.TAB      6       PO   FBA   133   23408    3     5
 4.     *.RCCYYQST.S.SW.COPYLIB       205     PO    FB    80    6160   48    50
 5.     *.RCCYYQST.S.SW.IDCMCARD      13      PO    FB    80    6160    1    15
 6.     *.RCCYYQST.S.SW.ONL.LD        162     PO     U     0   23200   23    50
 7.     *.RCCYYQST.S.SW.PROCLIB       4       PO    FB    80    6160   50    50
 8.     *.RCCYYQST.S.SW.PROG.LIST     166     PO   FBA   133   23408 1217   200
 9.     *.RCCYYQST.S.SW.UTILLIB       11      PO    FB    80    6160    1    15
10.     *.RCCYYQST.S.TX.DOCUMENT      43      PO   FBA   110   27500 601     20
11.     *.RCCYYQST.S.TX.RLSE.DOC      N/A     PS   FBA    90   27000   26    NA

Note:     Asterisk denotes prefix used at each Host site, and RCCYYQST denotes
           the Release number of the current release.

The DOCUMENT Library Members should be printed using the same characteristics
that have always been used.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VI. Testing Data in The Current Release                        Page 35
______________________________________________________________________________

VI.   TESTING DATA IN CURRENT RELEASE

 Input and output files have been provided for Host Sites to use to verify
 the correct installation of this Release. Specifically, the input consists
 of:

 1. A 'base' of test data made up of prior input from previous Releases.
 2. Site 3 file for Run 02, containing input related to this Release.

 This input/output may also be used in regression testing of the CWF system.
 The following actions must be taken in order to create the same response
 files, with 95% accuracy, contained on the current Release files:

 1. Delete/define all VSAM files once (only) before running the test sequence
    outlined below. (See instructions in Chapter INSTALL of the CWF Systems
    Documentation - Create CWF VSAM Datasets.)

 2. If there are test history files in existence from previous CWF Releases,
    delete the existing test history files and run the HISTINIT utility.
    (Described in CWF Systems Documentation Chapter INSTALL - Create CWF VSAM
    Datasets.)

 3. Run the 'REGRLOAD' Utility before beginning the test cycles.

 The characteristics and environment that existed when the test cycles were
 run for this Release are listed in this section.

 1. Enter transactions using the HISU transaction:
     Record 1 - Maximum tasks for sites '--', '00', '01', '02', and '03'
                were set to '1'.
     Record 3 - Transactions per batch were set to '5'.

 2. The Contractor File Maintenance (HIIN) for Contractor Number '00000'
    contained the following characteristics:

      SITE INDICATOR          KS
      PROCESS TYPE            O
      MULTI SWITCH            Y
      5% DUPE EDITS:          ACTIVE
      SKELETON CMN:           ACTIVE
      CONTRACTOR EDIT:        TEST
      PART A DATE CHECKING:   INACTIVE
      PART B DATE CHECKING:   INACTIVE
      MSP DATE CHECKING:      INACTIVE
      ESRD DATE CHECKING:     INACTIVE
      CMN DATE CHECKING:      INACTIVE
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VI. Testing Data in Current Release                            Page 36
______________________________________________________________________________

 3. Production files that directly affect the results of the cycles include:

     CLIA
     Carrier Table
     Edit Table
     HCPCS

 4. Chapter INSTALL contains instructions for executing CMS Maintenance OSA
    Claims Cycles, and Claims Processing Cycles.

 5. The data should be input using the sequence listed in this section.

   Note:   Asterisk denotes prefix used at each Host site and the Release
           number of the current release

     HCFA 01 - 21,488 CMS MAINTENANCE TRANSACTIONS TO SET UP
           Types: HIID, HIHO, HIHR, HIBR, HIPA, HIPB, HIXR, HIAR, HICA,
                    HINT, HISP, HHMO, HICB, etc.

            INPUT FILES: *.RCCYYQST.H.TD.BENES(HCFA01)
                    Input to CABHCFA Step (CABLIN DD) in CABMDC06
                           Header Date 2007180

     HCFA 03 - 48,644 MISCELLANEOUS CMS MAINTENANCE TRANSACTIONS
           Types: HIHO, HIPA, HIPB, HIID, and HHMO

            INPUT FILE: *.RCCYYQST.H.TD.BENES(HCFA03)
                    Input to CABHCFA Step (CABLIN DD) in CABMDC06
                         Header Date 2007181

     HCAL 03 - 171 HCAL HICR MAINTENANCE TRANSACTIONS
           Types: HCAL

            INPUT FILE: *.RCCYYQST.H.TD.BENES(HCAL03)
                    Input to REPRHICR Step (INFILE DD) in CABMDC06

            OUTPUT FILE:   Response output is not created for this run; no
                            expected results are included.

     NOTE: HCFA01 and 03 can be concatenated and executed in one RUN.
           HCAL03 can also be taken into same run for HICR process.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VI. Testing Data in Current Release                            Page 37
______________________________________________________________________________

         RUN 02 - ONLINE SITE PROCESSING WITH A TOTAL OF 88,020 CLAIMS IN 3 FILE
                  SETS:

               INPUT FILES:    *.RCCYYQST.H.TD.SITE.CLM(RUN02S01)
                                - Site location is 00080 (PF 1)
                                - Header Date is 2007180
                                - Contains 6,826 transactions
                                Types: HUIP, HUOP, HUHC, HUHH, HUSP, HUBC, and HURD

                               *.RCCYYQST.H.TD.SITE.CLM(RUN02S02)
                               - Site location is 00190 (PF 2)
                               - Header Date is 2007180
                               - Contains 158 transactions
                               Types: HUIP, HUHC, HUSP, and HURD

                               *.RCCYYQST.H.TD.SITE.CLM(RUN02S03)
                               - Site location is 00210 (PF 3)
                               - Header Date is 2007181
                               - Contains 81,036 transactions
                               Types: HUIP, HUOP, HUBC, HUSP, HURD, HUDC, HUCM,
                               HUHC, HUBO, and HUHH

               OUTPUT FILES:   Expected Satellite response files, which should
                               match 95% with actual results received after the
                               input files, above, have been processed.

                               *.RCCYYQST.H.TD.SITE.RESP(RUN02R01)
                               - Response file for input file 'RUN02S01'
                               - Site location is 00080

                               *.RCCYYQST.H.TD.SITE.RESP(RUN02R02)
                               - Response file for input file 'RUN02S02'
                               - Site location is 00190

                               *.RCCYYQST.H.TD.SITE.RESP(RUN02R03)
                               - Response file for input file 'RUN02S03'
                               - Site location is 00210

 Special Testing Instructions:      None


 Note:     The asterisks above denote prefix used at each Host site, and RCCYYQST
            denotes the Release number of the current release.



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VI. Testing Data in Current Release                            Page 38
______________________________________________________________________________

TESTING INFORMATIONAL UNSOLICITED RESPONSES THROUGH THE CABBUMP PROCESS.

In the event that it is necessary to test Informational Unsolicited Responses
through CABBUMP as part of release testing, the following jobs must be
executed as part of the CABBUMP process to generate and send Information
Unsolicited Responses to Satellites.

C05 _ CABBUMP _         Processes HHMO transaction and writes CWF Cancel Only
                        claims to CWFHOST.TRANS(+1).

HRCV _ Receive OSA _    Reads the CWFHOST.TRANS and write to Site 97.

H05 _                   Load OSA Site 97 queries.

HISC for Site 97 _      Processes CWF Cancel Only claims and generates
                        Informational Unsolicited Responses. These Responses
                        will be written to the CABNS97 file by H10, below.
                        (Note: CABOT* files may be empty if no regular OSA
                        queries exist).

H10 _                   Sorts and Backups OSA CABOT97 file. It copies CABNS97
                        from a VSAM file to a QSAM file, which is input to
                        HXMT.

HXMT _                  Split OSA Reply records. It reads the QSAM CABNS97
                        and creates Host Transmission files.

HRCV _                  Takes in Host transmission files (created by HXMT) and
                        creates Satellite Response files including OSA, if
                        any. The Satellite Response files are transmitted to
                        the appropriate Satellite.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 39
______________________________________________________________________________

VII. DETAILED DESCRIPTION OF CHANGES

A.        HOST CHANGE REQUEST

     1.     00023761    ITF CORRECTION ISSUES

     REQUESTOR ID: CWFM1000

   IMPACT:
 (X) Host
 ( ) Satellite Part A Inpatient
 ( ) Satellite Part A Outpatient
 ( ) Satellite Part B
 ( ) RHHI
 ( ) DMERC

   REASON FOR CHANGE:
 When keying claims via ITF (Internal Testing Facility), there
 are several fields that are not being initialized and saved
 correctly. This applies to claims that are selected and
 entered via the HITF transaction, as well as to new claims.
 The following fields are affected:

      - HUOP, Outpatient Claims
        HUON-COINSURANCE-AMOUNT
        HUON-REDUCED-COINSUR-AMOUNT
        HUON-FIN-LIM

      - HUBC, Part-B Claims
        HUDC-DOB
        HUDC-SCRN-SAVNG
        HUDC-DME-ALLOW
        HUDC-UNITS

      - HUIP, Inpatient Claims
        HUIN-VALUE-AMTV

          ** NOTE:     the same is true for HUON-VALUE-AMTV for
                       transaction HUOP, Outpatient Claims

 During alpha testing for the R2008.1 release an additional
 problem with the ITF HIIP and HIOP transactions was found.
 When keying fewer than the maximum nine characters in the
 Intermediary Number, the Intermediary Number is truncated
 and saved with an incorrect value. This applies to the
 following two fields:
______________________________________________________________________________
2020 Company, LLC                                           Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 40
______________________________________________________________________________


   - HUIP, Inpatient Claims
     HUIN-INTERMEDIARY

   - HUOP, Outpatient Claims
     HUON-INTERMEDIARY

 This CR will also address the number of consistency edits
 that are displayed in ITF. Currently only three consistency
 edits are displayed in ITF, even though a maximum of four
 can be displayed. This CR will increase the consistency
 edit display to four.

 This CR will also correct the hard-coded screen length for
 screen HIOPMP1I in the HITF HIOPCOP module. The incorrect
 length for the first screen causes subsequent screens to
 display incorrectly when returning error messages.

 Please Note: The original description includes a comment
              regarding ITF transactions being saved with an
              incorrect length. Unless this issue can be
              recreated, a fix will not be included with this CR.

   NEW BUSINESS REQUIREMENTS:

 Requirement 1
 CR 00019392 modified the ITF Outpatient module HIOPCIP to allow/
 preserve non-numeric data keyed into the two line item fields,
 HUON-COINSURANCE-AMOUNT and HUON-REDUCED-COINSUR-AMOUNT. CR
 00019392 also introduced two new consistency edits, '61#A' and '61#B',
 which were set due to non-numeric values present in these two
 fields. However, a subsequent CR, 00019929, deactivated the '61#A'
 and '61#B' consistency edits.

 CR 00023761 will modify the handling of the HUON-COINSURANCE-AMOUNT
 and HUON-REDUCED-COINSUR-AMOUNT fields so that the two fields
 are coded in the same manner as all other financial line item
 numeric fields.

 Requirement 2
 In the ITF outpatient module, HIOPCIP, the HUON-FIN-LIM
 field is not consistently initialized to zeros when no data
 has been keyed into the field. When using the ITF PF11
 Repeat Key function, the Financial Limit field is only
 populated when the HUON-FIN-LIM field contains a numeric
 value.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 41
______________________________________________________________________________


 CR 00023761 will modify the handling of the HUON-FIN-LIM field
 so that it is coded in the same manner as all other financial
 line item numeric fields.

 Requirement 3
 Although the HUBC and HUDC transactions do not share the
 same ITF modules, they do share the same copybook layouts.
 Therefore, the ITF HUBC Part-B module, HIBCCIP, should
 initialize the following packed numeric HUDC fields to zeros:

 HUDC-DOB
 HUDC-SCRN-SAVNG
 HUDC-DME-ALLOW
 HUDC-UNITS

 CR 00023761 will initialize the HUDC fields with zeros.

 Requirement 4
 In the ITF inpatient module, HIIPCIP, the HUIN-VALUE-AMTV
 field is not consistently initialized to zeros. The same is
 true for the HUON-VALUE-AMTV in the ITF outpatient module,
 HIOPCIP. This causes the 36 Value Code Amounts to be saved
 with a combination of low-values and zeros.

 CR 00023761 will modify the handling of the Value Code Amount
 fields for both ITF inpatient and ITF outpatient claims. All
 Value Code Amount fields that do not contain a Value Code will
 be initialized to zeros rather than to low-values.

 Requirement 5
 When entering ITF inpatient and outpatient claims via the HIIP
 and HIOP transactions, the HUIN-INTERMEDIARY and HUON-INTERMEDIARY
 fields are truncated and the 'A008' consistency edit is set. In
 both the ITF HIIPCIP and HIOPCIP modules, the number of characters
 that are moved to the HUIN-INTERMEDIARY and HUON-INTERMEDIARY
 fields are based on a calculation. This calculation does not
 contain the maximum length (9) of the Intermediary number when
 claims are keyed via HIIP and HIOP, causing the truncation to
 occur.

 CR 00023761 will remove the calculation from ITF modules HIIPCIP
 and HIOPCIP as it is not needed when populating the Intermediary
 numbers.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 42
______________________________________________________________________________

 Requirement 6
 Currently only three consistency edits are displayed in ITF,
 however, four consistency edits are returned on the response
 files within the CWF test cycles.

 CR 00023761 will ensure that four consistency edits are displayed
 in ITF.

 Requirement 7
 The hard-coded screen length for the first ITF HIOP screen,
 HIOPMP1I, is not consistent between the HIOPCIP and HIOPCOP
 modules. This causes any returned edits to display incorrectly
 when paging to subsequent screens, truncating the first position.

 CR 00023761 will change the HIOPMP1I length from 1261 to 1262 in
 the ITF module HIOPCOP.

   EVENT-RESPONSE LIST:

 Event 1.1
 Select an HIOP record from HITF, leaving the Coinsurance
 and Reduced Coinsurance amounts blank.
 Save the claim to both the ISA and ITF files.

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 The Coinsurance and Reduced Coinsurance amount fields contain
 zeros or the original value, not spaces or low-values.

 Event 1.2
 Select an HIOP record from HITF, spacing out the Coinsurance
 and Reduced Coinsurance amount fields with the space bar.
 Save the claim to both the ISA and ITF files.

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 The Coinsurance and Reduced Coinsurance amount fields contain
 zeros, not spaces or low-values.

 Event 1.3
 Select an HIOP record from HITF, erasing the Coinsurance and
 Reduced Coinsurance amount fields with the Erase EOF key.
 Save the claim to both the ISA and ITF files.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 43
______________________________________________________________________________

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 The Coinsurance and Reduced Coinsurance amount fields contain
 zeros, not spaces or low-values.

 Event 1.4
 Enter a new HIOP record, leaving the Coinsurance and Reduced
 Coinsurance amounts blank.
 Save the claim to both the ISA and ITF files.

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 The Coinsurance and Reduced Coinsurance amount fields contain
 zeros, not spaces or low-values.

 Event 1.5
 Enter a new HIOP record, spacing over the Coinsurance and
 Reduced Coinsurance amounts with the space bar.
 Save the claim to both the ISA and ITF files.

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 The Coinsurance and Reduced Coinsurance amount fields contain
 zeros, not spaces or low-values.

 Event 1.6
 Enter a new HIOP record, erasing the Coinsurance and
 Reduced Coinsurance amounts with the Erase EOF key.
 Save the claim to both the ISA and ITF files.

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 The Coinsurance and Reduced Coinsurance amount fields contain
 zeros, not spaces or low-values.

 Event 2.1
 Select an HIOP record from HITF, leaving the Financial Limit
 field blank.
 Save the claim to both the ISA and ITF files.



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 44
______________________________________________________________________________

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 The Financial Limit field contains zeros or the original value,
 not spaces or low-values.

 Event 2.2
 Select an HIOP record from HITF, spacing out the Financial
 Limit field with the space bar.
 Save the claim to both ISA and ITF files.

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 The Financial Limit field contains zeros, not spaces or low-values.

 Event 2.3
 Select an HIOP record from HITF, erasing the Financial Limit
 field with the Erase EOF key.
 Save the claim to both ISA and ITF files.

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 The Financial Limit field contains zeros, not spaces or low-values.

 Event 2.4
 Select an HIOP record from HITF. Using the PF11 Repeat Key,
 add a new Line Item.
 Save the claim to both the ISA and ITF files.

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 The Financial Limit field contains zeros or the value of
 the repeated line, not spaces or low-values.

 Event 2.5
 Enter a new HIOP record, leaving the Financial Limit
 field blank.
 Save the claim to both the ISA and ITF files.

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 The Financial Limit field contains zeros, not spaces or
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 45
______________________________________________________________________________

 low-values.

 Event 2.6
 Enter a new HIOP record, spacing over the Financial Limit
 field with the space bar.
 Save the claim to both the ISA and ITF files.

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 The Financial Limit field contains zeros, not spaces or low-values.

 Event 2.7
 Enter a new HIOP record, erasing the Financial Limit field
 with the Erase EOF key.
 Save the claim to both the ISA and ITF files.

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 The Financial Limit field contains zeros, not spaces or low-values.

 Event 2.8
 Enter a new HIOP record. Using the PF11 Repeat Key, add a
 new Line Item.
 Save the claim to both the ISA and ITF files.

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 The Financial Limit field contains zeros or the value of
 the repeated line, not spaces or low-values.

 Event 3.1
 Select an HIBC record from HITF.
 Save the claim to both the ISA and ITF files.

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 The HUDC-DOB, HUDC-SCRN-SAVNG, and HUDC-DME-ALLOW fields are
 initialized to zeros, not spaces or low-values.

 Event 3.2
 Enter a new HIBC record.
 Save the claim to both the ISA and ITF files.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 46
______________________________________________________________________________


Response
Using Max Data-Util (U.10.16), view the saved record in the
ISA and ITF VSAM files.
The HUDC-DOB, HUDC-SCRN-SAVNG, and HUDC-DME-ALLOW fields are
initialized to zeros, not spaces or low-values.

Event 4.1
Select an HIIP record from HITF.
Save the claim to both the ISA and ITF files.

Response
Using Max Data-Util (U.10.16), view the saved record in the
ISA and ITF VSAM files.
All Value Amounts with no Value Code contain zeros, not spaces
or low-values.

Event 4.2
Select an HIOP, HIHH, and HIHC record from HITF.
Save the claim to both the ISA and ITF files.

Response
Using Max Data-Util (U.10.16), view the saved record in the
ISA and ITF VSAM files.
All Value Amounts with no Value Code contain zeros, not spaces
or low-values.

Event 4.3
Select an HIIP record from HITF, spacing out one of the
Value Code and Value Amount fields with the space bar.
Save the claim to both the ISA and ITF files.

Response
Using Max Data-Util (U.10.16), view the saved record in the
ISA and ITF VSAM files.
The Value Amount field contains zeros, not spaces or low-values.

Event 4.4
Select HIOP, HIHH, and HIHC records from HITF, spacing out
one of the Value Code and Value Amount fields with the space bar.
Save the claims to both the ISA and ITF files.

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 The Value Amount field contains zeros, not spaces or low-values.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 47
______________________________________________________________________________


 Event 4.5
 Enter a new HIIP record.
 Save the claim to both the ISA and ITF files.

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 All Value Amounts with no Value Code contain zeros, not spaces
 or low-values.

 Event 4.6
 Enter new HIOP, HIHH, and HIHC records.
 Save the claims to both the ISA and ITF files.

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 All Value Amounts with no Value Code contain zeros, not spaces
 or low-values.

 Event 4.7
 Enter a new HIIP record, spacing out one of the Value Code
 and Value Amount fields with the space bar.
 Save the claim to both the ISA and ITF files.

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 The Value Amount field contains zeros, not spaces or low-values.

 Event 4.8
 Enter new HIOP, HIHH, and HIHC records, spacing out one of the
 Value Code and Value Amount fields with the space bar.
 Save the claim to both the ISA and ITF files.

 Response
 Using Max Data-Util (U.10.16), view the saved record in the
 ISA and ITF VSAM files.
 The Value Amount field contains zeros, not spaces or low-values.

 Event 5.1
 Enter a new HIIP record that contains '00400' in the
 Intermediary number field.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 48
______________________________________________________________________________

Response
The claim is accepted and the 'A008' edit is not set.

Event 5.2
Enter new HIOP, HIHH, and HIHC records that contain '00400'
in the Intermediary number field.

Response
The claim is accepted and the 'A008' edit is not set.

Event 5.3
Enter a new HIIP record that contains '00230SDA' in the
Intermediary number field.

Response
The claim is accepted and the 'A008' edit is not set.

Event 5.4
Enter new HIOP, HIHH, and HIHC records that contain
'00230SDA' in the Intermediary number field.

Response
The claim is accepted and the 'A008' edit is not set.

Event 6.1
Select HIOP, HIHH, and HIHC records from ITF. Modify the
records to cause four or more consistency edits to be set.

Response
Four consistency edits are returned and are viewable on the screen.

Event 6.2
Enter new HIOP, HIHH, and HIHC records that will cause four or more
consistency edits to be set.

Response
Four consistency edits are returned and are viewable on the screen.

Event 6.3
Select an HIIP record from HITF. Modify the record to cause
four or more consistency edits to be set.

Response
Four consistency edits are returned and are viewable on the screen.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 49
______________________________________________________________________________

Event 6.4
Enter a new HIIP record that will cause 4 or more consistency
edits to be set.

Response
Four consistency edits are returned and are viewable on the screen.

Event 7.1
Select HIOP, HIHH, and HIHC records from ITF.      Modify the records
to cause edits to be set.

Response
When paging through the returned screens, the edits are displayed
correctly, with no truncation of the first position.

Event 7.2
Enter new HIOP, HIHH, and HIHC records.      Modify the records to
cause edits to be set.

Response
When paging through the returned screens, the edits are displayed
correctly, with no truncation of the first position.

The Entity List includes only NEW acronyms and terminology
that is currently not in use in CWF.

Entity List: N/A

Areas Affected by the Problem.
  1. ITF (Internal Testing Facility)

Solution Criteria: N/A

  EDITS AFFECTED:   None

  INSTALLATION INSTRUCTIONS:   None

  SYSTEMS DOCUMENTATION AFFECTED:     None

  SATELLITE SYSTEM MODIFICATIONS:     None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 50
______________________________________________________________________________

B.        SATELLITE CHANGE REQUESTS

     1.     00025445   PART A ADJUSTMENTS ON ADD HISTORY EDITS IN ERROR ON TRNG AUX

     REQUESTOR ID: CWFM2000

   IMPACT:
 (X) Host
 ( ) Satellite Part A Inpatient
 (X) Satellite Part A Outpatient
 ( ) Satellite Part B
 ( ) Hospice
 ( ) Home Health
 ( ) DMERC

   REASON FOR CHANGE:
 When HUOP claims are purged they are removed from the Beneficiary's
 claim history, but not from the Beneficiary's Auxiliary file. When
 the data from the original claim is added back to the Beneficiary's
 claim history it is added back with Action Code '7'.

 When an adjustment is performed against an Action Code '7' record,
 the adjustment is rejecting in error against the 'TRNG' (DSMT,
 MNTT, and VISN) and 'SMOK' Auxiliary file. Since the adjustment is
 submitted with a new ICN, the new ICN does not match the ICN on the
 Auxiliary file.

 CWF must read the 'ORIG ICN' field on the Add History record
 when matching the ICN on the Auxiliary file. Using the 'ORIG
 ICN' for matching will perform the debit/credit correctly
 and will then no longer set the edits in error.

     NEW BUSINESS REQUIREMENTS:

 Requirement 1
 CWF must properly perform both the debit/credit parts of an
 adjustment when an incoming HUOP record contains Action
 Code '3' and the adjustment is against a record in history
 that contains an Action Code '7'.

 To perform the debit/credit of the adjustment correctly, and
 no longer set error codes '538L', '538M', '538N', or '538P'
 against the DSMT and MNTT Auxiliary files, CWF must read the
 'Original ICN' field on the Action Code '7' claim and match
 that ICN against the ICN on the auxiliary file.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 51
______________________________________________________________________________

 Requirement 2
 CWF must properly perform both the debit/credit parts of an
 adjustment when an incoming HUOP record contains Action
 Code '3' and the adjustment is against a record in history
 that contains an Action Code '7'.

 To perform the debit/credit of the adjustment correctly, and
 no longer set error code '539E' against the SMOK Auxiliary
 file, CWF must read the 'Original ICN' field on the Action
 '7' claim and match that ICN against the ICN on the auxiliary
 file.

 Requirement 3
 CWF must properly perform both the debit/credit parts of an
 adjustment when an incoming HUOP record contains Action
 Code '3' and the adjustment is against a record in history
 that contains an Action Code '7'.

 To perform the debit/credit of the adjustment correctly, and
 no longer set error code '538X' against the VISN Auxiliary
 file, CWF must read the 'Original ICN' field on the Action
 '7' claim and match that ICN against the ICN on the auxiliary
 file.

   EVENT-RESPONSE LIST:

 Event 1.1
 Submit an HUOP adjustment for a Beneficiary that has services
 posted to the DSMT Auxiliary file. The adjustment is against a
 claim posted to the Beneficiary's history that contains an
 Action Code '7'.

 Response
 The incoming adjustment reads the original ICN and does not
 set the '538L' or the '538M'.

 The minutes from the debit/credit portion of the adjustment
 are displayed correctly.

 Event 1.2
 Submit an HUOP adjustment for a Beneficiary that has services
 posted to the MNTT Auxiliary file. The adjustment is against a
 claim posted to the Beneficiary's history that contains an
 Action Code '7'.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 52
______________________________________________________________________________

 Response
 The incoming adjustment reads the original ICN and does not
 set the '538N' or the '538P'.

 The minutes from the debit/credit portion of the adjustment
 are displayed correctly.

 Event 2.1
 Submit an HUOP adjustment for a Beneficiary that has services
 posted to the SMOK Auxiliary file. The adjustment is against a
 claim posted to the Beneficiary's history that contains an
 Action Code '7'.

 Response
 The incoming adjustment reads the original ICN and does not
 set the '538E'.

 The days/minutes from the debit/credit portion of the adjustment
 are displayed correctly.

 Event 3.1
 Submit an HUOP adjustment for a Beneficiary that has services
 posted to the VISN Auxiliary file. The adjustment is against a
 claim posted to the Beneficiary's history that contains an
 Action Code '7'.

 Response
 The incoming adjustment reads the original ICN and does not
 set the '538X'.

 The sessions from the debit/credit portion of the adjustment
 are displayed correctly.

   EDITS AFFECTED:

 a. Error Code:      538L   ( )New (X)Modified ( )Deleted
 Disposition:        UR

 Type of Record:     OUTP

 Error Message:
 More than '10' hours DSMT paid in initial year.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 53
______________________________________________________________________________

 Set Condition for edit '538L':

 Note:   Total time for each line item is calculated by
         multiplying the number of units/services by '30'
         minutes.

 Note:   The initial year for DSMT is the '12' month period
         following the initial date.

         When the initial date is on or after 07/01/2007, the
         initial year is no longer the '12' month period
         following the initial date, but rather, the initial
         year ends with 12/31 of that initial year.

 When an HUOP claim contains a DSMT HCPCS code and the
 associated units cause the total time for the DSMT initial
 year to exceed '10' hours, set the '538L' error code.

 When the No-Pay code equals 'N', bypass this edit.

 When the Total Charge equals the Non-Covered Charge, bypass
 this edit.

 When an incoming HUOP record with Action Code '3' is received
 and the record in history is an Action Code '7', bypass this
 edit.

 Trailer Information: '08'


 b. Error Code:    538M   ( )New (X)Modified ( )Deleted
 Disposition:      UR

 Type of Record:   OUTP

 Error Message:
 More than '2' hours follow-up DMST paid.

 Set Condition for edit '538M':

 Total time for each line item is calculated by multiplying the
 number of units by 30 minutes.

 The initial year for DSMT is the 12 month period following the
 initial date. When the initial date is on or after
 07/01/2007, the initial year is no longer the '12' month
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 54
______________________________________________________________________________

period following the initial date, but rather, the initial
year ends with 12/31 of that initial year.

Follow-up years are based on 12 month increments after the
initial year. When the initial date is on or after
07/01/2007, the first follow-up year begins with 01/01 of the
year following the initial year.

When an HUOP claim contains a DSMT HCPCS code and the
associated units cause the total time for any follow-up year
to exceed 2 hours, set the '538M' error code.

When an incoming HUOP record with Action Code '3' is received
and the record in history is an Action Code '7', bypass this
edit.

Trailer Information: '08'


c. Error Code:    538N   ( )New (X)Modified ( )Deleted
Disposition:      UR

Type of Record:   OUTP

Error Message:
More than '10' hours MNTT paid in initial year.

Set Condition for edit '538N':

Note:   Total time for each line item is calculated by
        multiplying the number of units by '30' minutes for
        HCPCS code '97804', '15' minutes for all other MNTT
        HCPCS codes.

Note:   The initial year for MNTT is the initial calendar year.
        When an HUOP claim contains a MNTT HCPCS code and the
        associated units cause the total time for the initial calendar
        year to exceed 3 hours, set the '538N' error code.

When the No-Pay code equals 'N', bypass this edit.

When the Total Charge equals the Non-Covered Charge, bypass
this edit.

 When an incoming HUOP record with Action Code '3' is received
 and the record in history is an Action Code '7', bypass this edit.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 55
______________________________________________________________________________


 Trailer Information: '08'


 d. Error Code:    538P   ( )New (X)Modified ( )Deleted
 Disposition:      UR

 Type of Record:   OUTP

 Error Message:
 More than '2' hours follow- up MNTT paid.

 Set Condition for edit '538P':

 Note:   Total time for each line item is calculated by
         multiplying the number of units by '30' minutes for
         HCPCS code '97804', '15' minutes for all other MNTT
         HCPCS codes.

 Note:   The initial year for MNTT is the initial calendar year.
         Follow-up years are the calendar years following the
         initial year.

 When a HUOP claim contains a MNTT HCPCS code and the
 associated units cause the total time for any follow-up year
 to exceed '2' hours, set the '538P' error code.

 When the No-Pay code equals 'N', bypass this edit.

 When the Total Charge equals the Non-Covered Charge, bypass
 this edit.

 When an incoming HUOP record with Action Code '3' is received
 and the record in history is an Action Code '7', bypass this edit.

 Trailer Information: '08'


 e. Error Code:    539E   ( )New (X)Modified ( )Deleted
 Disposition:      UR

 Type of Record:   OUTP

 Error Message:
 Medicare does not pay for more than '8' sessions of Smoking
 Cessation Counseling in '12' months.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 56
______________________________________________________________________________


 Set Condition for edit '539E':

 If an incoming Outpatient record has HCPCS code 'G0375',
 or 'G0376' with a Service Date on or after 10/03/2005
 and the number of units will cause the number of units on
 an existing Smoking Cessation Training period on the TRNGAUX
 file to exceed a total of '8', set the '539E' error code.

 When the No-Payment Code is 'B' or 'N', bypass the edit.

 When the No-Payment Code is not present, but the Non-Covered
 Charge for the detail line item is equal to the Total Charge
 bypass the edit.

 When the Action Code is '4' (Cancel Only), bypass the edit.

 When the Action Code is '7' (History Bill), bypass the edit.

 When an incoming HUOP record with Action Code '3' is received
 and the record in history is an Action Code '7', bypass this
 edit.

 Trailer Information: '08'


 f. Error Code:    538X   ( )New (X)Modified ( )Deleted
 Disposition:      UR

 Type of Record:   OUTP

 Error Message:
 Prior to 04/01/2008:
 The incoming claim will cause the 9 hour limit to be
 exceeded.

 Set Condition for edit '538X':
 If the incoming Part B record contains HCPCS codes
 'G9041', 'G9042', 'G9043' or 'G9044' and the Date of
 Service is on, or after 04/03/2006 and within the 90 day
 initial service window, and the incoming claim will cause
 the '9' hour limit to be exceeded, set the '538X' error
 code.

 04/01/2008 and later:
 The incoming claim will cause the 12 hour limit to be exceeded.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 57
______________________________________________________________________________


 If the incoming Part B record contains HCPCS codes
 'G9041', 'G9042', 'G9043' or 'G9044' and the Date of
 Service is on, or after 04/01/2008 and will cause
 the 12 hour limit to be exceeded, set the '538X' error
 code.

 If the Non-Payment Code equals 'B' or 'N', bypass this edit.

 If the Action Code equals '4' (Cancel Only), bypass this edit.

 If the Action Code equals '7' (History Bill), bypass this
 edit.

 When an incoming HUOP record with Action Code '3' is received
 and the record in history is an Action Code '7', bypass this
 edit.

 Trailer Information: 08

   INSTALLATION INSTRUCTIONS:   None

   SYSTEMS DOCUMENTATION AFFECTED:

     EDITUTIL              MODIFY EDIT '538L', '538M', '538N', AND
                           '538P' TO NOT SET FOR A BENEFICIARY THAT
                           HAS A 'DSMT' OR 'MNTT' AUXILIARY FILE WHEN
                           AN ADJUST AGAINST AN ACTION CODE '7'
                           HISTORY CLAIM.

     EDITUTIL              MODIFIY EDIT '538X' TO NOT SET FOR A
                           BENEFICIARY THAT HAS A VISN AUX FILE WHEN
                           AN ADJ AGAINST AN ACTION CODE '7' HISTORY
                           CLAIM.

     EDITUTIL              MODIFIY EDIT '539E' TO NOT SET FOR A
                           BENEFICIARY THAT HAS A SMOK AUX FILE WHEN
                           AN ADJ AGAINST AN ACTION CODE '7' HISTORY
                           CLAIM.

   SATELLITE SYSTEM MODIFICATIONS:     None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 58
______________________________________________________________________________

   2.   00025520   RECEIVING 7261 IN ERROR

   REQUESTOR ID: ALBCBS1000

   IMPACT:
 (X) Host
 ( ) Satellite Part A Inpatient
 ( ) Satellite Part A Outpatient
 (X) Satellite Part B
 ( ) Hospice
 ( ) Home Health
 ( ) DMERC

   REASON FOR CHANGE:
 When there are multiple SNF stays in history CWF is not
 returning the actual From and Thru Date on Trailer '13' for
 A/B Crossover edit '7261' for non-therapy services for
 SNF Consolidated Billing.

   NEW BUSINESS REQUIREMENTS:

 Requirement 1
 When an incoming Part B claim is rejected with A/B
 Crossover edit '7261' for non-therapy services and
 there are multiple SNF claims in history CWF should
 return on Trailer '13' the actual From and Thru Date
 of the claim that caused the SNF Consolidated reject.

   EVENT-RESPONSE LIST:

 Event 1.1
 Posted to history are multiple SNF Inpatient Part A claims
 (21x) in history.

 An incoming Part B claim is received with a non-therapy
 HCPCS code(s). The detail From and Thru Date is within
 one of the posted SNF Inpatient Part A claims (21x).

 Response
 A/B Crossover edit '7261' is set. Trailer '13' displays the
 correct From and Thru Date that caused the reject. Also,
 Trailer '31' indicates the correct HCPCS code.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 59
______________________________________________________________________________

The Entity List includes only NEW acronyms and terminology
that is currently not in use in CWF.

Entity List: N/A

Areas Affected by the Problem.
  1. A/B Crossover module
  2. Trailer

Solution Criteria: N/A

  EDITS AFFECTED:   None

  INSTALLATION INSTRUCTIONS:     None

  SYSTEMS DOCUMENTATION AFFECTED:       None

  SATELLITE SYSTEM MODIFICATIONS:       None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 60
______________________________________________________________________________

   3.   00025567   CLAIMS LOOPING WITH U5340

   REQUESTOR ID: ALBCBS1000

   IMPACT:
 (X) Host
 (X) Satellite Part A Inpatient
 ( ) Satellite Part A Outpatient
 ( ) Satellite Part B Outpatient
 ( ) Hospice
 ( ) Home Health
 ( ) DMERC

   REASON FOR CHANGE:
 CWF is incorrectly calculating the Lifetime Reserve Psychiatric
 Days from the Beneficiary's Master Record when the incoming
 Psychiatric claim's Dates of Service links two spells. Once
 the incoming claim is received the Beneficiary will run out of
 Psychiatric Days however, regular days will be remaining. CWF
 is returning utilization edit '5340' (Claim indicates benefits
 remaining) and returning incorrect Lifetime Psychiatric Days
 in the Trailer '09'. The claim has the correct covered days
 submitted but indicates Benefits Exhaust due to the Psychiatric
 Days will be exhausted.

   NEW BUSINESS REQUIREMENTS:

 Requirement 1
 CWF should not incorrectly calculate the Lifetime Reserve
 Psychiatric Days remaining when the Dates of Service link
 two spells. If the BENE has enough PSYCH Days remaining,
 CWF should reduce based on the incoming claim's days and not
 return utilization edit '5340' with incorrect Lifetime
 Reserve Psychiatric Days in Trailer '09'.

 Note:
 When a Beneficiary's regular days are not exhausted but
 the psychiatric days will be exhausted due to the incoming
 claim which will link two spells, CWF should allow Benefits
 Exhaust based on the psychiatric days are no longer
 available.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 61
______________________________________________________________________________

  EVENT-RESPONSE LIST:

Note:
The events below are examples:

Event 1.1
A Beneficiary that has only '16' lifetime psychiatric
days remaining exists. This Beneficiary will also
have regular days remaining however, the benefits
exhaust will be due to the psychiatric days. An HUIP
record with '16' covered psychiatric days and the
remaining non-covered days with Occurrence Code 'A3' to
indicate Benefits Exhaust is received that links two
existing spells.

Response
The record is accepted, and utilization edit '5340' is not set.
The Trailer '09' will include the accepted claim data.

Event 1.2
A Beneficiary that has '19' lifetime psychiatric days
remaining exists. The Beneficiary will have regular days
remaining however, the benefits exhaust will be due to the
psychiatric days. An HUIP record with '16' covered psychiatric
days and the remaining non-covered days with Occurrence Code
'A3' to indicate Benefits Exhaust is received that links
two existing spells.

Response
The record is rejected, and utilization edit '5340' is set.
Trailer '09' is returned with '19' days reflected in
Lifetime Reserve Psychiatric.

The Entity List includes only NEW acronyms and terminology
that is currently not in use in CWF.

Entity List: N/A

Areas Affected by the Problem.
  1. Inpatient/SNF Reply Record - CABESA2R

Solution Criteria: N/A




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 62
______________________________________________________________________________

   EDITS AFFECTED:   None

   INSTALLATION INSTRUCTIONS:   None

   SYSTEMS DOCUMENTATION AFFECTED:     None

   SATELLITE SYSTEM MODIFICATIONS:     None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 63
______________________________________________________________________________

   4.   00025598   5699 - REPORTING OF HEMATOCRIT AND HEMOGLOBIN TEST RESULTS

   REQUESTOR ID: CWFM1000

   IMPACT:
 (X) Host
 ( ) Satellite Part A Inpatient
 ( ) Satellite Part A Outpatient
 (X) Satellite Part B
 ( ) Hospice
 ( ) Home Health
 (X) DMERC

   REASON FOR CHANGE:
 Effective 01/01/2008, the Centers for Medicare & Medicaid
 Services (CMS) is implementing an expanded reporting requirement
 for all claims billing for administrations of an erythropoiesis
 stimulating agent (ESA). Hematocrit or hemoglobin readings are
 already required for ESRD claims for administrations of an ESA.
 Therefore, this instruction does not pertain to '72X' claims for
 renal dialysis facilities. Effective 01/01/2008, all other
 claims for ESA administrations will also require the reporting
 of either the most recent hematocrit or hemoglobin reading.

   NEW BUSINESS REQUIREMENTS:

 Requirement 1
 Create two new fields in the detail line level for the
 transmit record to CWF for HUBC and HUDC. First field will
 be a 2-byte alpha-numeric field for Test Type and the
 second will be a 3-byte numeric field for Test Results
 (decimal implied xx.x).

 Requirement 2
 Create two new    fields in the detail line level on ITF for
 HIBC and HIDC.    First field will be a 2-byte alpha-numeric
 field for Test    Type and the second will be a 3-byte numeric
 field for Test    Results (decimal implied xx.x).

         CABLE PART B CLAIM                       TRANSID   HIBC   PAGE
 LINE ITEM INFORMATION: (NOTE: THE SYSTEM WILL ACCEPT 1 THRU 13 LINES)
 CMS-PROVIDER-SPEC-CD 00 CMS-PROVIDER-TYPE 0 CMS-TYPE-SERVICE 0 CMS-DED-I
 CMS-ASSIGN-IND 0 CMS-PAY-PROC-IND 00 CMS-REIMB-IND 0 SUSP-DUP-REV-IND 0
 CMS-PROVIDER-IND 0 CMS-PAY-SCREEN-IND 0 CMS-MT 000 CMS-MT-IND ==>TT==>TR
 PROCEDURE-CODE 00000 MODFIERS 00 00 00 00 SUBMITTED-CHARGES 0000000
 ALLOWED-CHARGES 0000000 PROVIDER-TAX-NUM 0000000000 CARRIER-PROV-AREA 00
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 64
______________________________________________________________________________

 CARRIER-PROVIDER-SPEC-CD 00 CARRIER-TYPE-SERV 00 PLACE-OF-SERV 00
 SPECIALTY-PRICING-IND 0 SERV-FROM-DT 000000 SERV-THRU-DT 000000
 NPI 0000000000 NPI   NPI-GROUP            NUM-OF-SERVICES 000 ACTION-COD
 DIAG 00000 DME-COV-DATE 000000 DME-PURCHASE 000000 CLINIC-LAB-ID 000000
 CLINIC-LAB-AMT 000000 ANESTHESIA 000 DOC-IND 0 POP-ZIP 00000 PCT-ALLOWED
 DME-MED-NECESSARY 00 TOT-PAT-REIMB 0000000 TOT-PROV-REIMB 0000000
 TOT-CASH-DED-APP 00000 TOT-LIMIT/BLD-DED-PT-APP 000000 TOT-MSP-APP 00000
 MSP-CD 0 OTH-AMTS-APP - FLD1 0000000 FLD2 0000000 FLD3 0000000 FLD4 0000
 FLD5 0000000 OTH-AMTS-IND1 0 IND2 0 IND3 0 IND4 0 IND5 0 HP/SC IND 0
 PARTB COIN 0000000 UPIN 000000 PHYS-SUP-NO-IND 0 PHYS-SUP-ZIP-CD 0000000
 NPI-RENDERING-UPIN 0000000000 PRESCRIPTION 00000000000000000000000000000
 OVERRIDE EDIT1: 0000 EDIT2: 0000 EDIT3: 0000 EDIT4: 0000 EDIT5: 0000

 PF KEYS: 4 DONE NO DATA, 12 DONE WITH DATA, 7 UP, 8 DOWN, 11 REPEAT, ENT


 (CICSMAP HIDCM02)

 DMEPOS CLAIM                                   TRANSID    HIDC
 LINE ITEM INFORMATION: (NOTE: THE SYSTEM WILL ACCEPT 1 THRU 13 LINES)
 CMS-SUPPLIER-TYPE X CMS-TYPE-SERVICE X     CMS-SUPP-SPECIALTY XX
 CMS-ASSIGN-IND X CMS-PAY-PROC-IND X        CMS-REIMB-IND X CMS-DED-IND
 PROCEDURE-CODE XXXXX MODFIERS XX XX        SUSP-DUP-REV-IND==>TT ==> TR
 CMS-PAY-SCREEN-IND X           SUBMITTED-CHARGES XXXXXX     WAIVER-LIAB
 ALLOWED-CHARGES XXXXX SUPPLIER-TAX-NUM XXXXXX SCREEN-SUSPEND-IND XXXX
 SCREEN-RESULT-IND X DECISION-IND X SUPP-STATE-CODE XX PLACE-OF-SERV
 SPECIALTY-PRICING-IND X SERV-FROM-DT XXXXX SERV-THRU-DT XXXXX
 SUPPLIER XXXXXXX      NPI-IND   GRP NPI                 NUM-OF-ITEMS 001
 DIAGNOSIS XXXX   SCREEN-SAVE 0000000 PURCH-ALLOW 0008183 ACTION-CODE S
 NATL-DRUG-CD              UNITS 0000000000 NPI-SUPPLIER
 UNITS-IND 3 DOCUMENT-IND 1 TOT-PAT-REIMB 0000000 TOT-SUPP-REIMB 00065
 TOT-CASH-DED-APP 00000 TOT-MSP-APP 0000000
 MSP-CD    OTH-AMTS-APP - FLD1 0000000 FLD2 0000000 FLD3 0000000 FLD4 000
 FLD5 0000000 OTH-AMTS-IND - IND1 N IND2 N IND3 N IND4 N IND5 N
 PART-B-COIN 0001637 STATE-CODE KS NOC-CODE                 NCB-IND
 OVERRIDE EDIT1:       EDIT2:      EDIT3:      EDIT4:       EDIT5:


 PF KEYS: 4 DONE NO DATA, 12 DONE WITH DATA, 7 UP, 8 DOWN, 11 REPEAT, ENT

 Requirement 3
 Create two new fields in the detail line level for the claim
 in history on the Beneficiary Master Record for HUBC and HUDC.
 First field will be a 2-byte alpha-numeric field for Test
 Type and the second will be a 3-byte numeric field for Test
 Results (decimal implied xx.x). (CICSMAPS HIBCM02 & HIDCM02)
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 65
______________________________________________________________________________


 Requirement 4
 Create two new fields in the detail line level for the HIMR
 screens for PTBH and DMEH. First field will be a 2-byte
 alpha-numeric field for Test Type and the second will be a
 3-byte numeric field for Test Results (decimal implied xx.x).
 (CICSMAPS HMRMPB4 & HMRMDE4)

 (CICSMAPS HMRMPB4)

 NPI RENDER UPIN            PRESCRIPTION NUM
 ICN                 LINE__ OF     ENTRY CD  CLM FROM         CLM THRU
 FROM DTE THRU DTE PLACE TOS HCPCS      MOD      UNITS MTU/IND SUB CHG

 SPECIALTY PRICING IND        DIAG CD              CARRIER               CMS
 TOTAL PAT REIMB              PROV TAX NUMBER                     PROV IND
 TOTAL PROV REIMB             PROV AREA ==>TT XX ==>TR 00.0 PROV TYPE
 CASH DED APPLIED             PROV SPEC CODE                         PROV SPE
 CO INS                       PHYS: SUP NO           PROV NO
 CLINICAL LAB AMT                    ZIP CODE              UPIN       DOC IND
 CLINICAL LAB ID              PCT ALLOWED        HP/SC IND    ANESTHESIA
 MSP APPLIED                MSP        POP ZIP         TYPE SERVICE    ACT CD
 OTHER AMTS APPLIED 1:           2:           3:           4:           5:
 OTHER AMTS IND     1:           2:           3:           4:           5:
 DME RNT/COVDT            PURCHASE          NECESSARY      SUSP DUP REV IND
 CMS: ASSIGNMENT     PAY PROCESS      REIMB            DED       PAY SCREEN
 OVERRIDE EDIT1:       EDIT2:       EDIT3:        EDIT4:      EDIT5:


 (CICSMAP HMRMDE4)

 DMEH                         DMEPOS CLAIM HISTORY                 PAGE    3

 ICN 25073-1.1.1-4     LINE01 OF 01 ENTRY CD 1 CLM FROM 08/05/05 CLM THRU 0
 FROM/THRU PL/TOS HCPCS MOD       DIAG ITEMS UNITS/IND           SUB/ALLOW CHG
 08/05/05    12     K0002 RR KJ 7812 001              1.000          88.00
 08/05/05    R                                      3                81.83
 SPECIALTY PRICING IND D NPI SUPP                SUPPLIER          4779300004
 TOTAL PAT REIMB           ==>TT XX     ==>TR 00.0          SUPP TAX NUBER
 TOTAL SUPP REIMB      65.46                     SUPPLIER TYPE     3
 CASH DED APPLIED                                SUPP SPECIALTY 54
 CO INS                16.37 SUSP DUP REV IND    SUPPLIER STATE KS
 SCREEN SUS IND 1511 SCREEN RES IND E SCREEN SVGS                  DECISION IN
 NDC               NOC DESC                   RES STATE KS DME PURCHASE
 MSP APPLIED      0.00    MS   WAIVER N ACT CODE SW     DOC IND 1 NCBIND Y
 OTHER AMTS APPLIED 1:            2:       3:            4:            5:
______________________________________________________________________________
2020 Company, LLC                                               Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 66
______________________________________________________________________________

OTHER AMTS IND    1: N        2: N      3: N        4: N        5: N
CMS: ASSIGNMENT 3 PAY PROCESS A   REIMB 0 DED 0 PAY SCREEN 9
OVERRIDE EDIT1:      EDIT2:      EDIT3:      EDIT4:      EDIT5:

Requirement 5
Create two new fields in the detail line level for the
transmit records to NCH on HUBC and HUDC. First field will
be a 2-byte alpha-numeric field for Test Type and the second
will be a 3-byte numeric field for Test Results (decimal
implied xx.x).

  EVENT-RESPONSE LIST:

Event 1.1
An HUBC is received with data in the new fields created
for hematocrit/hemoglobin test type and test results.

Response
The record is accepted with the new fields in the line level.

Event 1.2
An HUDC is received with data in the new fields created
for hematocrit/hemoglobin test type and test results.

Response
The record is accepted with the new fields in the line level.

Event 2.1
An HIBC record is submitted in ITF with hematocrit/
hemoglobin test type and test results data provided
in the new fields.

Response
The ITF record displays the new fields for hematocrit/
hemoglobin test type and test results in the line
level.

Event 2.2
An HIDC record is submitted in ITF with hematocrit/
hemoglobin test type and test results data provided
in the new fields.

 Response
 The ITF record displays the new fields for hematocrit/
 hemoglobin test type and test results in the line
 level.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 67
______________________________________________________________________________


 Event 3.1
 An HUBC record is submitted with hematocrit/hemoglobin
 test type and test results data and accepted in CWF.

 Response
 The record is posted to the claim history file and
 displays the hematocrit/hemoglobin test type and test
 results in HIMR on the PTBH.

 Event 3.2
 An HUDC record is submitted with hematocrit/hemoglobin
 test type and test results data and accepted in CWF.

 Response
 The record is posted to the claim history file and
 displays the hematocrit/hemoglobin test type and test
 results in HIMR on the PTBH.

 Event 4.1
 An HUBC record is received with hematocrit/hemoglobin
 test type and test results data that is accepted in CWF.

 Response
 The new field is posted in HIMR on the PTBH.

 Event 4.2
 An HUDC record is received with hematocrit/hemoglobin
 test type and test results data that is accepted in CWF.

 Response
 The new field is posted in HIMR on the DMEH.

 Event 5.1
 An HUBC record is received with hematocrit/hemoglobin
 test type and test results data that is accepted in CWF.

 Response
 The new field and data is written to the HCFACLM file.

 Event 5.2
 An HUDC record is received with hematocrit/hemoglobin
 test type and test results data that is accepted in CWF.

 Response
 The new field and data is written to the HCFACLM file.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 68
______________________________________________________________________________


   EDITS AFFECTED:   None

   INSTALLATION INSTRUCTIONS:    None

   SYSTEMS DOCUMENTATION AFFECTED:

    COPYINTL                UPDATE THE HUBC/HUDC RECORD GOING TO CWF
                            FOR NEW TEST TYPE AND TEST RESULT FIELDS.

    COPYXTNL                UPDATE THE HUBC/HUDC RECORD GOING TO
                            HCFACLM FOR NEW TEST TYPE AND TEST RESULT
                            FIELDS.

    OVERHIMR                UPDATE HIMR SCREEN FOR PTBH/DMEH FOR NEW
                            NEW TEST TYPE AND TEST RESULT FIELDS.

    SCRHOST                 UPDATE ITF FOR HIBC/HIDC WITH NEW FIELDS.

    LAYBENE                 UPDATE PT B/DME FULL HISTORY WITH NEW
                            FIELDS.

   SATELLITE SYSTEM MODIFICATIONS:      None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 69
______________________________________________________________________________

   5.   00025623   HCPCS G0141 SETTING 7172 INCORRECTLY WHEN MULT. DIAG ON CLM

   REQUESTOR ID: CWFM1000

   IMPACT:
 (X) Host
 ( ) Satellite Part A Inpatient
 (X) Satellite Part A Outpatient
 (X) Satellite Part B
 ( ) Hospice
 ( ) Home Health
 ( ) DMERC

   REASON FOR CHANGE:
 A/B Crossover edit '7172' currently has logic for HCPCS
 'G0141' that is causing the edit to be set incorrectly.
 HCPCS 'G0141' should be removed from all logic of A/B
 Crossover edit '7172'.

   NEW BUSINESS REQUIREMENTS:

 Requirement 1
 Modify A/B Crossover edit '7172' by removing HCPCS 'G0141'
 from all edit logic.

   EVENT-RESPONSE LIST:

 Event 1.1
 An HUBC record is received with HCPCS 'G0141'. An HUOP
 record is in history for the same HCPCS and same Dates
 of Service of the incoming record.

 Response
 A/B Crossover edit '7172' is not set.

 Event 1.2
 An HUBC record is received with HCPCS 'G0123', 'P3000',
 'Q0060', 'Q0061', 'G0143', 'G0144', 'G0145', 'G0147',
 or 'G0148' and the diagnosis code 'V1589'. An HUOP record
 is in history for the same HCPCS and diagnosis code with
 same Dates of Service of the incoming record.

 Response
 A/B Crossover edit '7172' is set.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 70
______________________________________________________________________________

The Entity List includes only NEW acronyms and terminology
that is currently not in use in CWF.

Entity List: N/A

Areas Affected by the Problem.
  1. A/B Crossover module

Solution Criteria: N/A

  EDITS AFFECTED:

a. Error Code:      7172   ( )New (X)Modified ( )Deleted
Disposition: CR

Type of Record: OUTP, Pt. B Carrier

Error Message:
Outpatient or Part B claim Duplicate for screening PAP
smear.

Set Condition for edit '7172':

When the incoming Outpatient bill has a Diagnosis Code
equal 'V1589', and the incoming Outpatient has a claim line
with a HCPCS code equal to 'G0123', 'Q0060', 'Q0061' or
'P3000', set the '7172' error code.

When the incoming Part B bill contains a claim line with a
HCPCS code equal to 'G0123', 'P3000', 'Q0060', 'Q0061',
'G0143', 'G0144', 'G0145', 'G0147', or 'G0148',
and the incoming Part B bill contains a Diagnosis Code of
'V1589', set the '7172' error code.

When the incoming Part B bill contains a claim line with a
HCPCS code equal to 'G0123', 'P3000', 'Q0060', 'Q0061',
'G0143', 'G0144', 'G0144', 'G0145', 'G0147', or
'G0148' and the incoming Part B bill contains a Diagnosis
Code of 'V1589', set the '7172' error code.

When the Part B Cancel Date is greater than zero, bypass
this edit.

When the history Part B Entry Code equals '3' or '9',
bypass this edit.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 71
______________________________________________________________________________

 When the history Part B Pay Denial Indicator equals zero,
 bypass this edit.

 When the Part B Payment Process Indicator is equal to 'B',
 'C', 'I', M', 'N' or 'O', bypass this edit.

 When the history Part B bill does not contain a claim line
 with a HCPCS code equal to 'G0123', 'Q0060', 'Q0061', or
 'P3000', bypass this edit.

 When the Part B HCPCS code Modifier '1', '2', '3' or '4' is
 equal to '26', bypass this edit.

 When the history Part B Diagnosis Code is not equal to
 'V1589', bypass this edit.

 When the incoming Part B Demonstration Number is equal to
 '31', bypass this edit.

 When the first two positions of the Outpatient bill type
 are not equal to '13', '14', '23', '24', '71' or '85',
 bypass this edit.

 When an incoming or history Outpatient claim with a Type of
 Bill '13x', '14x' or '85x' is received with the screening
 PAP smear HCPCS codes 'G0143-G0145' and 'G0147-G0148',
 and there is an incoming or history ASC claim (Type of Bill
 '83x') with the same or overlapping Dates of Service of the
 claim received, and the Date of Service is on or after
 01/01/1999, bypass this edit.

 When the incoming Outpatient bill contains an Occurrence
 Span Code '72' and the Occurrence Span Code From Date is
 not equal to the history Part B service From Date, bypass
 this edit.

 When the incoming Outpatient bill does not contain an
 Occurrence Span Code '72' and the incoming Outpatient
 service Thru Date is not equal to the history Part B
 service From Date, bypass this edit.

 Note: The claim lines on the incoming Part B bill are
       interrogated and the latest service Thru Date is
       stored as the Last Expense Date and the earliest
       service From Date are stored as the First Expense
       Date.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 72
______________________________________________________________________________


 When the incoming Part B First Expense Date is greater than
 the Outpatient service Thru Date, bypass this edit.

 When the incoming Part B Last Expense Date is less than the
 Outpatient service From Date, bypass this edit.

 When the history Outpatient claim bill source is not a '2'
 or '3' and the history Outpatient Action Code is a '2', '4'
 or '6' and the history Outpatient Transaction Code is equal
 to '6', bypass this edit.

 When the history Outpatient Cancel Date is greater than
 zero, bypass this edit.

 When the history Outpatient Action Code is equal to '7',
 bypass this edit.

 When the incoming Part B claim line item From Date is
 greater than the Outpatient service Thru Date, bypass this
 edit.

 When the incoming Part B claim line item Thru Date is less
 than the Outpatient service From Date, bypass this edit.

 When the incoming Part B Payment Process Indicator is equal
 to 'B', 'C', 'I', 'M', 'N', or 'O', bypass this edit.

 When the first two positions of the history Outpatient bill
 type are not equal to '13', '14', '23', '24', '71', or
 '85', bypass this edit.

 When the history Outpatient bill does not contain a line
 items with a HCPCS code equal to 'G0123', 'P3000', 'Q0060',
 or 'Q0061', bypass this edit.

 When the incoming Part B HCPCS code Modifier '1', '2', '3',
 or '4' is equal to '26', bypass this edit.

 When the history Outpatient bill contains an Occurrence
 Span Code '72', and the Occurrence Span Code From Date is
 not equal to the incoming Part B service From Date, bypass
 this edit.



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 73
______________________________________________________________________________

 When the history Outpatient bill does not contain a
 Occurrence Span Code '72', and the history Outpatient
 service From Date is not equal to the incoming Part B
 service Thru Date, bypass this edit.

 When the incoming Outpatient claim Demonstration Number is
 equal to '31', bypass this edit.

 When the No-Pay code is 'N', bypass this edit.

 When the incoming Outpatient claim Total Charge equals the
 Non-covered Charge, bypass this edit.

 Trailer Information: 08, 13

   INSTALLATION INSTRUCTIONS:   None

   SYSTEMS DOCUMENTATION AFFECTED:

    EDITABX               REMOVE HCPCS 'G0141' FROM EDIT '7172'
                          LOGIC.

   SATELLITE SYSTEM MODIFICATIONS:     None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 74
______________________________________________________________________________

   6.   00025634    CR7245 SETTING INCORRECTLY ON NON-COVERED ANTI-EMETIC

   REQUESTOR ID: CWFM1000

   IMPACT:
 (X) Host
 ( ) Satellite Part A Inpatient
 (X) Satellite Part A Outpatient
 ( ) Satellite Part B
 ( ) Hospice
 ( ) Home Health
 ( ) DMERC

   REASON FOR CHANGE:
 Outpatient claims and adjustment are rejecting incorrectly
 for A/B Crossover edit '7245' when the detail line item
 for anti-emetic is non-covered and there is no anti-cancer
 drug in history or on the incoming claim.

   NEW BUSINESS REQUIREMENTS:

 Requirement 1
 CWF should not set A/B Crossover edit '7245' when an
 incoming Outpatient or adjustment claim is submitted and
 the total charge equals the non-covered charge for the
 anti-emetic HCPCS code and there is no oral anti-cancer
 drug in history or on the incoming claim.

   EVENT-RESPONSE LIST:

 Event 1.1
 Submit an Outpatient claim or adjustment with a non-covered
 anti-emetic HCPCS code. The total charge equals the non-cover
 charge and there is no oral anti-cancer drug in history or
 on the incoming claim.

 Response
 A/B Crossover edit '7245' does not set.

 The Entity List includes only NEW acronyms and terminology
 that is currently not in use in CWF.

 Entity List: N/A

 Areas Affected by the Problem.
   1. A/B Crossover module
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 75
______________________________________________________________________________


 Solution Criteria: N/A

   EDITS AFFECTED:   None

   INSTALLATION INSTRUCTIONS:   None

   SYSTEMS DOCUMENTATION AFFECTED:     None

   SATELLITE SYSTEM MODIFICATIONS:     None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 76
______________________________________________________________________________

  7.   00025640   5756 REVISION TO CR 4294 LOW VISION REHAB DEMO

  REQUESTOR ID: CWFM2000

  IMPACT:
(X) Host
( ) Satellite Part A Inpatient
(X) Satellite Part A Outpatient
(X) Satellite Part B
( ) Hospice
( ) Home Health
( ) DMERC

  REASON FOR CHANGE:
CWF will need to modify the logic on the VISN Auxiliary
File to be based on calendar year and no longer during
a 90 day window for Dates of Service 04/01/2008 and after.
This will include a redesign of the VISN Aux File.

CWF will modify utilization edit '538X' (The incoming claim
will cause the limit to be exceeded) to set on HUBC or HUOP
records with Dates of Service on or after 04/01/2008 during a
calendar year when the 12 hour limit (48 units) has been met.

CWF will modify utilization edit '538Y' (The '90' day
period has past) to no longer set on HUBC or HUOP records
with Dates of Service on or after 04/01/2008.

  NEW BUSINESS REQUIREMENTS:

Requirement 1
Modify and redesign the VISN Auxiliary File logic to be based
on calendar year and no longer during a '90' day window for
Dates of Service 04/01/2008 and after. Continue to apply the
90 day window for Dates of Service prior to 04/01/2008 on
the VISN Auxiliary File.

Requirement 2
Modify the HIMR VISN Screen to allow the display of multiple
years. The Initial HIMR display will show the Pre 04/01/2008
VISN information if available, with the option of entering
a specific post 04/01/2008 year for review.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 77
______________________________________________________________________________

 VISN            LOW VISION DEMONSTRATION              PAGE     1 OF 1
 HIC 012345678A          LOCAL HOST              DOB 01/01/1901    SEX
 CORR 012345678A      NAME HENRY.HENRY.H,        DOD               SOURCE
 VSN 1
           INP 0000 OUT 0000 HOS 0000 PTB 0000 DME 0000 HHA 0000 BLK N
 DISPLAY CAL YR: XXXX    <<<<<<< New Enterable Field
 INITIAL DATE    06/22/2005               ACCUMULATED TIME    405
 90-DAY DATE     09/20/2005

       FROM       THRU                CLAIM
 HCPCS DATE       DATE       TIME     TYPE TOS      ICN/DCN
 G9041 06/22/2005 06/22/2005 405      B     Q       25640-1


 F2=MENU F3=RETURN F4=BENA F5=BENB F7=BWD F8=FWD F12=EXIT

 Note:   Due to SATELLITE/HOST processing limitations, this will
         be the initial screen for ALL VISN requests in HIMR.

         In the case where only post 04/01/2008 data is available
         for a beneficiary, this screen will show the 'YEAR' in
         the DISPLAY CAL YR: field and the Initial Date and
         90-DAY DATE will be blanked out. The earliest record
         available on the file will be displayed.

         The screen below in Requirement 3 will be displayed only
         if a valid year is input for and requested.

 Requirement 3
 If a valid year is keyed into the DISPLAY CAL YR: field, the
 VISN Calendar year information shall be displayed if available.
 The INITIAL DATE and 90-DAY DATE will be removed from the display
 since they are not applicable to the new requirements.

 VISN            LOW VISION DEMONSTRATION              PAGE     1 OF 1
 HIC 012345678A          LOCAL HOST              DOB 01/01/1901    SEX
 CORR 012345678A      NAME HENRY.HENRY.H,        DOD               SOURCE
 VSN 1
           INP 0000 OUT 0000 HOS 0000 PTB 0000 DME 0000 HHA 0000 BLK N
 DISPLAY CAL YR: 2008    <<<<<<< New Enterable Field
                                          ACCUMULATED TIME    405




       FROM       THRU               CLAIM
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 78
______________________________________________________________________________

 HCPCS DATE       DATE       TIME    TYPE   TOS   ICN/DCN
 G9041 06/22/2008 06/22/2008 405     B      Q     25640-2

 Requirement 4
 If at any time the 'DISPLAY CAL YEAR' field is input, the field must
 be validated for a viable year. If the year is invalid or if no
 VISN information is found for that year, an appropriate message
 will be returned.

 Keying ZEROS in the field at any point will cause either
 the pre 04/01/2008 data to be displayed or the earliest
 available year.

 Requirement 5
 The VISNAUX file must be modified to expand from 36 to 48
 occurrences and have the Key field expanded to include a 4
 digit year. The Key year for current existing records will
 be zeros. (Internal Changes to CWF)

 This requirement will encompass a 1 time conversion process,
 as well as all IDCAMS and VISNAUX file related updates.

 Requirement 6
 Modify utilization edit '538X' (The incoming claim will
 cause the limit to be exceeded) to set on HUBC or HUOP
 records with Dates of Service on or after 04/01/2008
 during a calendar year when a 12-hour limit (48 units) has
 been met. Continue to apply the logic for Dates of Service
 prior to 04/01/2008 using the '90' day window.

 Requirement 7
 Modify utilization edit '538Y' (The '90' day period has past)
 to no longer set on HUBC or HUOP records with Dates of Service
 on or after 04/01/2008. Continue to apply the '90' day logic
 in edit '538Y' for Dates of Service prior to 04/01/2008.

   EVENT-RESPONSE LIST:

 Event 1.1
 View a VISN Aux File that has data for Dates of Service
 04/01/2008 or after.

 Response
 The VISN Aux File reflects data based on calendar year.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 79
______________________________________________________________________________

Event 1.2
View a VISN Aux File that has data for Dates of Service
prior to 04/01/2008.

Response
The VISN Aux File reflects data based on a 90 day window.

Event 2.1
View a VISN Aux File with multiple year data that includes
Dates of Service prior to 04/01/2008 and after by entering
a specific post 04/01/2008 year review.

Response
The VISN Aux File will display pre 04/01/2008 VISN data
and post 04/01/2008 data.

Event 3.1
View a VISN AUX file with no pre 04/01/2008 data.

Response
The earliest available VISN calendar year data will
be displayed.

Event 4.1
Data is entered   in the VISN Aux File 'DISPLAY CAL
YEAR' field and   no VISN information for that year
is found or the   data entered in the VISN 'DISPLAY
CAL YEAR' field   is invalid.

Note: Keying ZEROS in the field at any point will cause either
      the pre 04/01/2008 data to be displayed or the earliest
      available year.

Response
Either an INVALID DATE ENTERED message or a NO DATA FOUND
FOR DATE ENTERED message will be displayed.

Event 5.1
Ensure the VISN will accept an display 36 occurrences
prior to 04/01/2008 and 48 occurrences after 04/01/2008.

Response
All occurrences are displayed accurately.



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 80
______________________________________________________________________________

 Event 6.1
 An HUOP record is received that contains HCPCS code
 'G9041', 'G9042', 'G9043' or 'G9044' with Dates of
 Service on, after 04/01/2008. The Beneficiary's 12 hour
 limit (48 units) has been met and the record is
 within the one calendar year window.

 Response
 The record is rejected, error code '538X' is set.

 Event 6.2
 An HUOP record is received that contains HCPCS code
 'G9041', 'G9042', 'G9043' or 'G9044' with Dates of
 Service prior to 04/01/2008. The Beneficiary's 9 hour
 limit (36 units) has been met and the record is
 within the '90' day window.

 Response
 The record is rejected, error code '538X' is set.

 Event 6.3
 An HUOP record is received that contains HCPCS code
 'G9041', 'G9042', 'G9043' or 'G9044' with Dates of
 Service on, after 04/01/2008. The Beneficiary's 9 hour
 limit (36 units) has not been met and the record is
 within the one calendar year window.

 Response
 The record is accepted, error code '538X' is not set.

 Event 6.4
 An HUOP record is received that contains HCPCS code
 'G9041', 'G9042', 'G9043' or 'G9044' with Dates of
 Service prior to 04/01/2008. The Beneficiary's 9 hour
 limit (36 units) has not been met and the record is
 within the '90' day window.

 Response
 The record is accepted, error code '538X' is not set.

 Event 6.5
 An HUBC record is received that contains HCPCS code
 'G9041', 'G9042', 'G9043' or 'G9044' with Dates of
 Service on, after 04/01/2008. The Beneficiary's 12 hour
 limit (48 units) has been met and the record is
 within the one calendar year window.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 81
______________________________________________________________________________


 Response
 The record is rejected, error code '538X' is set.

 Event 6.6
 An HUBC record is received that contains HCPCS code
 'G9041', 'G9042', 'G9043' or 'G9044' with Dates of
 Service prior to 04/01/2008. The Beneficiary's 9 hour
 limit (36 units) has been met and the record is
 within the '90' day window.

 Response
 The record is rejected, error code '538X' is set.

 Event 6.7
 An HUBC record is received that contains HCPCS code
 'G9041', 'G9042', 'G9043' or 'G9044' with Dates of
 Service on, after 04/01/2008. The Beneficiary's 12 hour
 limit (48 units) has not been met and the record is
 within the one calendar year window.

 Response
 The record is accepted, error code '538X' is not set.

 Event 6.8
 An HUBC record is received that contains HCPCS code
 'G9041', 'G9042', 'G9043' or 'G9044' with Dates of
 Service prior to 04/01/2008. The Beneficiary's 9 hour
 limit (36 units) has not been met and the record is
 within the '90' day window.

 Response
 The record is accepted, error code '538X' is not set.

 Event 7.1
 An HUOP record with HCPCS code 'G9041', 'G9042',
 'G9043', or 'G9044' is received with Dates of Service
 prior to 04/01/2008 and is after the '90' day window.

 Response
 The record is rejected, error code '538Y' is set.

 Event 7.2
 An HUOP record with HCPCS code 'G9041', 'G9042',
 'G9043', or 'G9044' is received with Dates of Service
 prior to 04/01/2008 and is within the '90' day window.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 82
______________________________________________________________________________


 Response
 The record is accepted, error code '538Y' is not set.

 The Entity List includes only NEW acronyms and terminology
 that is currently not in use in CWF.

 Entity List: N/A

 Areas Affected by the Problem.
   1. HUOPCUT - utilization edits
   2. HMRCVISN - VISN AUX transaction module
   3. HUVISNUT - VISN AUX EDIT MODULE
   4. HUCNCRUT - VISN online edits

 Solution Criteria: N/A

   EDITS AFFECTED:

 a. Error Code:      538X   ( )New (X)Modified ( )Deleted
 Disposition: UR

 Type of Record: Pt. B Carrier

 Error Message:
 The incoming claim will cause the limit to be exceeded.

 Set Condition for edit '538X':

 Prior to 04/01/2008:
 If the incoming Part B record contains HCPCS codes
 'G9041', 'G9042', 'G9043' or 'G9044' and the Date of
 Service is on, or after 04/03/2006 and within the 90 day
 initial service window, and the incoming claim will cause
 the 9 hour limit to be exceeded, set the '538X' error
 code.

 04/01/2008 and later:
 If the incoming Part B record contains HCPCS codes
 'G9041', 'G9042', 'G9043' or 'G9044' and the Date of
 Service is on, or after 04/01/2008 and will cause
 the 12 hour limit to be exceeded, set the '538X' error
 code.

 When the header Payment/Denial Indicator is '0', bypass
 the edit.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 83
______________________________________________________________________________


 When the detail Payment/Process Indicator is other than
 'A', 'R' or 'S', bypass the edit.

 When the Entry Code is '3' (Cancel Only), bypass the edit.

 When the Entry Code is '9' (Add History), bypass the edit.

 When the posted CNCRAUX record is a TECH Service, bypass
 the edit.

 Trailer Information: 08


 b. Error Code:    538X    ( )New (X)Modified ( )Deleted
 Disposition: UR

 Type of Record: OUTP

 Error Message:
 Prior to 04/01/2008:
 The incoming claim will cause the 9 hour limit to be exceeded.

 Set condition for edit '538X'
 If the incoming Part B record contains HCPCS codes
 'G9041', 'G9042', 'G9043' or 'G9044' and the Date of
 Service is on, or after 04/03/2006 and within the 90 day
 initial service window, and the incoming claim will cause
 the 9 hour limit to be exceeded, set the '538X' error
 code.

 04/01/2008 and later:
 The incoming claim will cause the 12 hour limit to be
 exceeded.

 If the incoming Part B record contains HCPCS codes
 'G9041', 'G9042', 'G9043' or 'G9044' and the Date of
 Service is on, or after 04/01/2008 and will cause
 the 12 hour limit to be exceeded, set the '538X' error
 code.

 If the Non-Payment Code equals 'B' or 'N', bypass this edit.

 If the Action Code equals '4' (Cancel Only), bypass this edit.

 If the Action Code equals '7' (History Bill), bypass this edit.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 84
______________________________________________________________________________


When an incoming HUOP record with Action Code '3' is received
and the record in history is an Action Code '7', bypass this
edit.

Trailer Information: 08


c. Error Code:    538Y    ( )New (X)Modified ( )Deleted
Disposition: UR

Type of Record: OUTP

Error Message:

Note: This edit is deactivated for claims with service dates
      04/01/2008 and later.

The '90' day period is past.

Set Condition for edit '538Y':

Pre 04/01/2008 only.
If the incoming Outpatient record contains HCPCS codes
'G9041', 'G9042', 'G9043', or 'G9044' and is received on or
after 04/03/2006 and the Date of Service is more than
90 days after the Initial Date, set the '538Y' error code.

If the Non-Payment Code equals 'B' or 'N', bypass this edit.

If the Action Code equals '4' (Cancel Only), bypass this edit.

If the Action Code equals '7' (History Bill), bypass this
edit.

Trailer Information: 08




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 85
______________________________________________________________________________

 d. Error Code:    538Y    ( )New (X)Modified ( )Deleted
 Disposition: UR

 Type of Record: Pt. B Carrier

 Error Message:

 Note: This edit is deactivated for claims with service dates
       04/01/2008 and later.

 The '90' day period is past.

 Set Condition for edit '538Y':

 Pre 04/01/2008 claims only.
 If the incoming Outpatient record contains HCPCS codes
 'G9041', 'G9042', 'G9043', or 'G9044' and is received on
 or after 04/03/2006 and the Date of Service is more than
 '90' days after the Initial Date, set the '538Y' error
 code.

 When the header Payment/Denial Indicator is '0', bypass
 the edit.

 When the detail Payment/Process Indicator is other than
 'A', 'R' or 'S', bypass the edit.

 When the Entry Code is '3' (Cancel Only), bypass the edit.

 When the Entry Code is '9' (Add History), bypass the edit.

 When the posted CNCRAUX record is a TECH Service, bypass
 the edit.

 Trailer Information: 08




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 86
______________________________________________________________________________

   INSTALLATION INSTRUCTIONS:

 ** Refer to CR 00025700 for the Installation Instructions for this CR. **

   SYSTEMS DOCUMENTATION AFFECTED:

    EDITLIST              MODIFY '538X' FOR CALENDAR YEAR.

    EDITLIST              MODIFY '538Y' FOR CALENDAR YEAR.

    EDITUTIL              MODIFY '538X' FOR CALENDAR YEAR.

    EDITUTIL              MODIFY '538Y' FOR CALENDAR YEAR.

    OVERHIMR              MODIFY VISN FOR CALENDAR YEAR.

    COPYINTL              MODIFY CABCVISN FOR CALENDAR YEAR.

   SATELLITE SYSTEM MODIFICATIONS:   None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 87
______________________________________________________________________________

   8.   00025641   5757- ADDL CWF EDITING FOR SNF CB PART II

   REQUESTOR ID: CWFM2000

   IMPACT:
 (X) Host
 (X) Satellite Part A Inpatient
 ( ) Satellite Part A Outpatient
 (X) Satellite Part B
 ( ) Hospice
 ( ) Home Health
 ( ) DMERC

   REASON FOR CHANGE:
 CWF shall modify A/B Crossover edits '7258' and '7259' to
 reject a Part B claim with therapy services that are within/
 overlap an SNF covered or non-covered stay that contains
 Occurrence Code '22' Date (Date Active Care Ended) with a
 Patient Status '30' and a discharge claim has not processed
 yet.

 CWF will generate an informational unsolicited response
 for a Part B claim for A/B Crossover edit '7258' and '7259'
 when an incoming SNF Inpatient Part A claim is received
 with an Occurrence Code '22' and there is no subsequent
 SNF discharge claim for the same Admission.

   NEW BUSINESS REQUIREMENTS:

 Requirement 1
 CWF must modify A/B Crossover edit '7258' to read
 history when a SNF Inpatient Part A claim (21x) has
 processed with Occurrence Code '22' and Patient Status
 '30' where there is no subsequent SNF discharge claim
 for the same Admission Date.

 A/B Crossover edit '7258' will set on the incoming
 Part B claim with therapy service when the From and
 Thru Date are greater than the Occurrence Code '22'
 Date and the Dates of Service overlap the Admission
 and Thru Date of the posted SNF claim with Patient
 Status '30'.

 Also, A/B Crossover edit '7258' will set on the
 incoming Part B claim with therapy service when the
 From and Thru Date are greater than the Occurrence
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 88
______________________________________________________________________________

 Code '22'   Date and the Dates of Service overlap the
 Admission   and Thru Date of the subsequent SNF claim
 posted to   history with Patient Status '30'. There
 is no SNF   discharge claim for the same Admission Date.

 Note: All Part B claim where the From and Thru Date
       are after the Occurrence Code '22' Date will
       set edit '7258' until the Discharge Date is
       received.

 Requirement 2
 CWF must modify A/B Crossover edit '7259' to read
 history when a SNF Inpatient Part A claim (21x) has
 processed with Occurrence Code '22' and Patient Status
 '30' where there is no subsequent SNF discharge claim
 for the same Admission Date.

 A/B Crossover edit '7259' will set on the incoming
 Part B claim with therapy services when the From and
 Thru Date is greater than the Occurrence Code '22' Date
 and the Dates of Service is within the Admission and
 Thru Date of the posted SNF claim with Patient Status
 '30'.

 Also, A/B Crossover edit '7259' will set on the
 incoming Part B claim with therapy services when the
 From and Thru Date are greater than the Occurrence
 Code '22' Date and the Dates of Service is within the
 Admission and Thru Date of the subsequent SNF claim
 posted to history with Patient Status '30'. There
 is no SNF discharge claim for the same Admission Date.

 Note: All Part B claim where the From and Thru Date
       are after the Occurrence Code '22' Date will
       set edit '7259' until the Discharge Date is
       received.

 Requirement 3
 CWF will modify the informational unsolicited process
 when an incoming SNF Inpatient Part A claim (21x) has
 an Occurrence Code '22' and Patient Status '30' and
 there is no subsequent SNF discharge claim for the
 the same Admission Date.

 CWF will generate an informational unsolicited response
 for A/B Crossover edit '7258' when the posted Part B claim
______________________________________________________________________________
2020 Company, LLC                                           Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 89
______________________________________________________________________________

 From and Thru Date is greater than the Occurrence Code '22'
 on the incoming SNF claim with patient status '30'. The
 Dates of Service overlap the Admission and Thru Date of
 the incoming SNF claim.

 CWF will generate an informational unsolicited response
 for A/B Crossover edit '7258' when the posted Part B claim
 From and Thru Date is greater than the Occurrence Code '22'
 Date and the Dates of Service overlap the Admission and Thru
 Date of the subsequent SNF claim posted to history with
 Patient Status '30'.

 Note: All Part B claims where the From and Thru Date are
       after the Occurrence Code '22' Date will generate an
       informational unsolicited response for edit '7258'
       even if the SNF Dates are not posted in CWF until
       the Discharge Date is received.

 Requirement 4
 CWF will modify the informational unsolicited process
 when an incoming SNF Inpatient Part A claim (21x) has
 an Occurrence Code '22' and Patient Status '30' and
 there is no subsequent SNF discharge claim for the
 the same Admission Date.

 CWF will generate an informational unsolicited response
 for A/B Crossover edit '7259' when the posted Part B claim
 From and Thru Date is greater than the Occurrence Code '22'
 on the incoming SNF claim with patient status '30'. The
 Dates of Service is within the Admission and Thru Date of
 the incoming SNF claim.

 CWF will generate an informational unsolicited response
 for A/B Crossover edit '7259' when the posted Part B claim
 From and Thru Date is greater than the Occurrence Code '22'
 Date and the Dates of Service is within the Admission and
 Thru Date of the subsequent SNF claim posted to history
 with Patient Status '30'.

 Note: All Part B claims where the From and Thru Date are
       after the Occurrence Code '22' Date will generate an
       informational unsolicited response for edit '7259'
       even if the SNF Dates are not posted in CWF until
       the Discharge Date is received.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 90
______________________________________________________________________________

  EVENT-RESPONSE LIST:

Event 1.1
Posted to history are multiple SNF Inpatient Part A claims
(21x). One claim has Occurrence Code '22' (Date Active Care
Ended) with Patient Status '30'. The discharge claim for the
SNF stay is not yet posted in history.

An incoming Part B claim is received with therapy services.
The From and Thru Date of the Part B claim is greater than
the Occurrence Code '22' Date (Date Active Care Ended)
and the Date of Service overlap the Admission and Thru Date
of the posted SNF claim.

Ex. SNF (21x) From 07/01/07 Thru 07/14/07 Pt St '30'
              Occurrence Code 22 Date 07/09/07
    Part B    From and Thru Date 07/10/07-07/21/07

Response
The incoming Part B claim is rejected, and error code '7258'
is set.

Event 1.2
Posted to history are multiple SNF Inpatient Part A claims
(21x). One claim has Occurrence Code '22' (Date Active Care
Ended) with Patient Status '30'. There is a subsequent
SNF Inpatient claim with Patient Status '30'. The discharge
claim for the SNF stay is not yet posted in history.

An incoming Part B claim is received with therapy services.
The From and Thru Date is greater than the Occurrence Code
'22' Date and overlaps the Admission and Thru Date of the
subsequent SNF claim posted to history with Patient Status
'30'.

Ex. SNF (21x) From 07/01/07 Thru   07/09/07 Pt St '30'
              Occurrence Code 22   Date 07/09/07
    SNF (21x) From 07/10/07 Thru   07/21/07 Pt St '30'
    Part B    From 07/12/07 Thru   07/25/07

Response
The incoming Part B claim is rejected, and error code '7258'
is set.



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 91
______________________________________________________________________________

 Event 2.1
 Posted to history are multiple SNF Inpatient Part A claims
 (21x). One claim has Occurrence Code '22' (Date Active Care
 Ended) with Patient Status '30'. The discharge claim for the
 SNF stay is not yet posted in history.

 An incoming Part B claim is received with therapy services.
 The From and Thru Date of the Part B claim is greater than
 the Occurrence Code '22' Date (Date Active Care Ended)
 and the Date of Service is within the Admission and Thru Date
 of the posted SNF claim.

 Ex. SNF (21x) From 07/01/07 Thru 07/14/07 Pt St '30'
               Occurrence Code 22 Date 07/09/07
     Part B    From and Thru Date 07/11/07-07/12/07

 Response
 The incoming Part B claim is rejected, and error code '7259'
 is set.

 Event 2.2
 Posted to history are multiple SNF Inpatient Part A claims
 (21x). One claim has Occurrence Code '22' (Date Active Care
 Ended) with Patient Status '30'. There is a subsequent
 SNF Inpatient claim with Patient Status '30'. The discharge
 claim for the SNF stay is not yet posted in history.

 An incoming Part B claim is received with therapy services.
 The From and Thru Date is greater than the Occurrence Code
 '22' Date and is within the Admission and Thru Date of the
 subsequent SNF claim posted to history with Patient Status
 '30'.

 Ex. SNF (21x) From 07/01/07 Thru   07/09/07 Pt St '30'
               Occurrence Code 22   Date 07/09/07
     SNF (21x) From 07/10/07 Thru   07/31/07 Pt St '30'
     Part B    From 07/12/07 Thru   07/12/07

 Response
 The incoming Part B claim is rejected, and error code '7259'
 is set.

 Event 3.1
 Posted to history is a Part B claim with therapy services.
 The From and Thru Date of the Part B claim is greater than
 the Occurrence Code '22' Date (Date Active Care Ended)
______________________________________________________________________________
2020 Company, LLC                                           Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 92
______________________________________________________________________________

 and the Date of Service overlap the Admission and Thru
 Date of the incoming SNF claim.

 An incoming SNF Inpatient Part A claim (21x) is received
 with Patient Status '30' and Occurrence Code '22'.

 Response
 The incoming SNF Inpatient Part A claim (21x) is processed.
 An informational unsolicited response is generated for the
 Part B claim for A/B Crossover edit '7258'. Trailer '24'
 along with '31' is returned.

 Event 3.2
 Posted to history is a Part B claim with therapy services.
 The From and Thru Date of the Part B claim is greater than
 the Occurrence Code '22' Date (Date Active Care Ended)
 and overlaps the Admission and Thru Date of the incoming
 subsequent SNF claim.

 An incoming SNF Inpatient Part A claim (21x) with Patient
 Status '30' and Occurrence Code '22' is processed. A
 subsequent SNF Inpatient Part A claim is received with a
 Patient Status '30'.

 Response
 The incoming SNF Inpatient Part A claim (21x) is processed.
 An informational unsolicited response is generated for the
 Part B claim for A/B Crossover edit '7259'. Trailer '24'
 along with '31' is returned.

 Event 4.1
 Posted to history is a Part B claim with therapy services.
 The From and Thru Date of the Part B claim is greater than
 the Occurrence Code '22' Date (Date Active Care Ended)
 and the Date of Service is within the Admission and Thru
 Date of the incoming SNF claim.

 An incoming SNF Inpatient Part A claim (21x) is received
 with Patient Status '30' and Occurrence Code '22'.

 Response
 The incoming SNF Inpatient Part A claim (21x) is processed.
 An informational unsolicited response is generated for the
 Part B claim for A/B Crossover edit '7258'. Trailer '24'
 along with '31' is returned.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 93
______________________________________________________________________________

 Event 4.2
 Posted to history is a Part B claim with therapy services.
 The From and Thru Date of the Part B claim is greater than
 the Occurrence Code '22' Date (Date Active Care Ended)
 and is within the Admission and Thru Date of the incoming
 subsequent SNF claim.

 An incoming SNF Inpatient Part A claim (21x) with Patient
 Status '30' and Occurrence Code '22' is processed. A
 subsequent SNF Inpatient Part A claim is received with a
 Patient Status '30'.

 Response
 The incoming SNF Inpatient Part A claim (21x) is processed.
 An informational unsolicited response is generated for the
 Part B claim for A/B Crossover edit '7259'. Trailer '24'
 along with '31' is returned.

 The Entity List includes only NEW acronyms and terminology
 that is currently not in use in CWF.

 Entity List: N/A

 Areas Affected by the Problem.
   1. A/B Crossover module
   2. Informational unsolicited module

 Solution Criteria: N/A

      EDITS AFFECTED:

 a. Error Code:         7258   ( )New (X)Modified ( )Deleted
 Disposition: CR

 Type of Record: Pt. B Carrier

 Error Message:
 For a Part B claim, the detail From and Thru Date overlaps
 the Admission and Discharge Date of a SNF Inpatient Part A
 claim (21x) and a Therapy HCPCS code(s) is present.

 OR

 For a Part B claim, the detail from or Thru Date overlaps
 the detail line item Date of Service of a SNF Inpatient
 Part B claim (22x) and a Therapy HCPCS code(s) is present.
______________________________________________________________________________
2020 Company, LLC                                           Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 94
______________________________________________________________________________


Set Condition for edit '7258':

2008 Therapy HCPCS code(s)

     'G0281'   'G0283'   'G0329'   '0019T'   '0029T'
     '90901'   '92506'   '92507'   '92508'   '92526'
     '92597'   '92605'   '92606'   '92607'   '92608'
     '92609'   '92610'   '92611'   '92612'   '92614'
     '92616'   '95831'   '95832'   '95833'   '95834'
     '95851'   '95852'   '96105'   '96110'   '96111'
     '96115'   '96125'   '97001'   '97002'   '97003'
     '97004'   '97010'   '97012'   '97016'   '97018'
     '97022'   '97024'   '97026'   '97028'   '97032'
     '97033'   '97034'   '97035'   '97036'   '97039'
     '97110'   '97112'   '97113'   '97116'   '97124'
     '97139'   '97140'   '97150'   '97530'   '97532'
     '97533'   '97535'   '97537'   '97542'   '97597'
     '97598'   '97602'   '97605'   '97606'   '97750'
     '97755'   '97760'   '97761'   '97762'   '97799'

When a Part B claim is submitted with a Therapy HCPCS
code(s) and the detail From and Thru Date overlaps the
Admission or Discharge Date of a SNF Inpatient Part A
claim (21x),

OR

When a Part B claim is submitted with a Therapy HCPCS
code(s) and the detail From and Thru Date overlaps the
Admission or Discharge Date of a SNF Inpatient Part B
claim (22x),

OR

When a Part B claim is submitted with a Therapy HCPCS
code(s) and the From and Thru Date of the Part B claim
is greater than the Occurrence Code '22' Date and the
Date of Service overlap the Admission and Thru Date
of a posted SNF Inpatient Part A claim (21x), set the
'7258' error code.

When the incoming Part B claim detail Thru Date equals the
SNF Inpatient Part A (21x) Admission Date, bypass this
edit.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 95
______________________________________________________________________________

 When the incoming Part B claim detail From Date equals the
 SNF Inpatient Part A (21x) Discharge Date, and the Patient
 Status is other than '30', bypass this edit.

 When the incoming Part B claim detail From Date equals the
 SNF Inpatient Part B (22x) Thru Date, bypass this edit.

 When the incoming Part B claim detail Thru Date equals the
 SNF Inpatient Part B (22x) From Date, bypass this edit.

 When an incoming Part B claim is submitted with Entry Code
 '3' (cancel only), bypass this edit.

 When an incoming Part B claim is submitted with Entry Code
 '9' (add to history), bypass this edit.

 When an incoming Part B claim is submitted with a header
 Payment/Denial Indicator is other than '1', '2', '3', '5',
 '6', '7', '8', '9', 'A', or 'B', bypass this edit.

 When an incoming Part B claim is submitted with a detail
 Payment/Process Indicator is other than 'A', 'R', or 'S',
 bypass this edit.

 When the detail Edit Override Table has '7258' present,
 bypass this edit.

 When the incoming Part B claim is submitted with one of
 the following HCPCS code(s) and the Provider Specialty is
 not equal to '65', '67', or '88'. The detail From or Thru
 Date is on, or after 07/01/2004 and until 12/31/2004 and
 overlaps the posted SNF Inpatient A claim (21x), bypass
 this edit.

 Effective 07/01/2004
 '29065', '29075', '29085',   '29086',   '29105',   '29125',
 '29126', '29130', '29131',   '29200',   '29220',   '29240',
 '29260', '29280', '29345',   '29365',   '29405',   '29445',
 '29505', '29515', '29520',   '29540',   '29550',   '29580',
 '29590', or '64550'.

 Terminated 12/31/2004
 '29065', '29075', '29085', '29086', '29105', '29125',
 '29126', '29130', '29131', '29200', '29220', '29240',
 '29260', '29280', '29345', '29365', '29405', '29445',
 '29505', '29515', '29520', '29540', '29550', '29580',
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 96
______________________________________________________________________________

 '29590'.

 When the incoming Part B claim is submitted with one of
 the following HCPCS code(s) and the Provider Specialty is
 not equal to '65', '67', or '88'. The detail From or Thru
 Date is on, or after 07/01/2004 and until 12/31/2004 and
 overlaps the posted SNF Inpatient B claim (22x), bypass
 this edit.

 Effective 07/01/2004
 '29065', '29075', '29085',   '29086',   '29105',   '29125',
 '29126', '29130', '29131',   '29200',   '29220',   '29240',
 '29260', '29280', '29345',   '29365',   '29405',   '29445',
 '29505', '29515', '29520',   '29540',   '29550',   '29580',
 '29590', or '64550'.

 Terminated 12/31/2004
 '29065', '29075', '29085',   '29086',   '29105',   '29125',
 '29126', '29130', '29131',   '29200',   '29220',   '29240',
 '29260', '29280', '29345',   '29365',   '29405',   '29445',
 '29505', '29515', '29520',   '29540',   '29550',   '29580',
 '29590'.

 When the history SNF Inpatient Part A (21x) claim Cancel
 Date is greater than zero, bypass this edit.

 When the history SNF Inpatient Part A (21x) claim has a
 No-Pay Code equal to 'B', 'C', 'N', or 'R', bypass this
 edit.

 When the history SNF Inpatient Part B (22x) claim Cancel
 Date is greater than zero, bypass this edit.

 When the history SNF Inpatient Part B (22x) claim Action
 Code is equal to '7' (add to history), bypass this edit.

 When the history SNF Inpatient Part B (22x) claim has a
 No-Pay Code equal to 'B' or 'N', bypass this edit.

 When the incoming Part B claim detail From and Thru Date
 is within the Span Code '74' From and Thru Date of the
 posted SNF Inpatient claim (21x) in history and the
 incoming Part B claim is received with a therapy
 HCPCS code(s) and the detail From and Thru Date is on
 or after 04/01/2001, bypass this edit.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 97
______________________________________________________________________________

 Trailer Information: '08', '13', '31'


 b. Error Code:     7259     ( )New (X)Modified ( )Deleted
 Disposition: CR

 Type of Record: Pt. B Carrier

 Error Message:
 For the Part B claim, the detail From and Thru Date is
 within the Admission and Discharge Date of a SNF Inpatient
 Part A claim (21x) and a Therapy HCPCS code(s) is present.

 OR

 For the Part B claim, the detail From and Thru Date is
 within the detail line item Date of Service (if not present
 use the From or Thru Date) of a SNF Inpatient Part B claim
 (22x) and a Therapy HCPCS code(s) is present.

 Set Condition for edit '7259':

 2008 Therapy HCPCS code(s)

      'G0281'   'G0283'    'G0329'   '0019T'   '0029T'
      '90901'   '92506'    '92507'   '92508'   '92526'
      '92597'   '92605'    '92606'   '92607'   '92608'
      '92609'   '92610'    '92611'   '92612'   '92614'
      '92616'   '95831'    '95832'   '95833'   '95834'
      '95851'   '95852'    '96105'   '96110'   '96111'
      '96115'   '96125'    '97001'   '97002'   '97003'
      '97004'   '97010'    '97012'   '97016'   '97018'
      '97022'   '97024'    '97026'   '97028'   '97032'
      '97033'   '97034'    '97035'   '97036'   '97039'
      '97110'   '97112'    '97113'   '97116'   '97124'
      '97139'   '97140'    '97150'   '97530'   '97532'
      '97533'   '97535'    '97537'   '97542'   '97597'
      '97598'   '97602'    '97605'   '97606'   '97750'
      '97755'   '97760'    '97761'   '97762'   '97799'

 When a Part B claim is submitted with a Therapy HCPCS
 code(s) and the detail From and Thru Date is within the
 Admission and Discharge Date of a SNF Inpatient Part A
 claim (21x), set the '7259' error code.

 OR
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 98
______________________________________________________________________________


When a Part B claim is submitted with a Therapy HCPCS
code(s) and the detail From and Thru Date is within the
Admission and Discharge Date of a SNF Inpatient Part B
claim (22x), set the '7259' error code.

OR

When a Part B claim is submitted with a Therapy HCPCS
code(s) and the detail From and Thru Date is greater
than the Occurrence Code '22' Date and the Date of
Service is within the Admission and Thru Date of a SNF
Inpatient Part A claim (21x), set the '7259' error code.

When an incoming Part B claim detail From Date equals the
SNF Inpatient Part A (21x) Discharge Date and the Patient
Status is other than '30', bypass this edit.

When an incoming Part B claim detail From Date equals the
SNF Inpatient Part B (22x) Thru Date, bypass this edit.

When an incoming Part B claim detail Thru Date equals the
SNF Inpatient Part A (21x) Admission Date, bypass this
edit.

When the incoming Part B claim detail Thru Date equals the
SNF Inpatient Part B (22x) From Date, bypass this edit.

When an incoming Part B claim is submitted with Entry Code
'3' (cancel only), bypass this edit.

When an incoming Part B claim is submitted with Entry Code
'9' (add to history), bypass this edit.

When an incoming Part B claim is submitted with a header
Payment/Denial Indicator is other than '1', '2', '3', '5',
'6', '7', '8', '9', 'A', or 'B', bypass this edit.

When an incoming Part B claim is submitted with a detail
Payment/Process Indicator is other than 'A', 'R', or 'S',
bypass this edit.

When the detail Edit Override Table has '7259' present,
bypass this edit.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                           Page 99
______________________________________________________________________________

 When the incoming Part B claim is submitted with
 one of the following HCPCS code(s) and the Provider
 Specialty is not equal to '65', '67', or '88'. The
 detail From or Thru Date is on, or after 07/01/2004,
 and overlaps the posted SNF Inpatient Part A claim
 (21x), bypass this edit.

 Effective 07/01/2004

 '29065',   '29075', '29085',   '29086',   '29105',   '29125',
 '29126',   '29130', '29131',   '29200',   '29220',   '29240',
 '29260',   '29280', '29345',   '29365',   '29405',   '29445',
 '29505',   '29515', '29520',   '29540',   '29550',   '29580',
 '29590',   or '64550'.

 Terminated 12/31/2004
 '29065', '29075', '29085',     '29086',   '29105',   '29125',
 '29126', '29130', '29131',     '29200',   '29220',   '29240',
 '29260', '29280', '29345',     '29365',   '29405',   '29445',
 '29505', '29515', '29520',     '29540',   '29550',   '29580',
 '29590'.

 When the incoming Part B claim is submitted with one of
 the following HCPCS code(s) and the Provider Specialty is
 not equal to '65', '67', or '88'. The detail From or Thru
 Date is on, or after 07/01/2004 and until 12/31/2004 and
 overlaps the posted SNF Inpatient B claim (22x), bypass
 this edit.

 Effective 07/01/2004
 '29065', '29075', '29085',     '29086',   '29105',   '29125',
 '29126', '29130', '29131',     '29200',   '29220',   '29240',
 '29260', '29280', '29345',     '29365',   '29405',   '29445',
 '29505', '29515', '29520',     '29540',   '29550',   '29580',
 '29590', or '64550'.

 Terminated 12/31/2004
 '29065', '29075', '29085',     '29086',   '29105',   '29125',
 '29126', '29130', '29131',     '29200',   '29220',   '29240',
 '29260', '29280', '29345',     '29365',   '29405',   '29445',
 '29505', '29515', '29520',     '29540',   '29550',   '29580',
 '29590'.

 When the history SNF Inpatient Part A (21x) claim Cancel
 Date is greater than zero, bypass this edit.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 100
______________________________________________________________________________

 When the history SNF Inpatient Part A (21x) claim has
 an No-Pay Code equal to 'B', 'C', 'N', or 'R', bypass this
 edit.

 When the history SNF Inpatient Part B (22x) claim Cancel
 Date is greater than zero, bypass this edit.

 When the history SNF Inpatient Part B (22x) claim Action
 Code is equal to '7' (add to history), bypass this edit.

 When the history SNF Inpatient Part B (22x) claim has a
 No-Pay Code equal to 'B' or 'N', bypass this edit.

 When the incoming Part B claim detail From and Thru Date
 is within the Span Code '74' From and Thru Date of the
 posted SNF Inpatient claim (21x) in history and the
 incoming Part B claim is received with a therapy
 HCPCS code(s) and the detail From and Thru Date is on
 or after 04/01/2001, bypass this edit.

 Trailer Information: '08', '13', '31'

   INSTALLATION INSTRUCTIONS:   None

   SYSTEMS DOCUMENTATION AFFECTED:

    EDITABX               MODIFY EDIT '7258'.

    EDITABX               MODIFY EDIT '7259'.

   SATELLITE SYSTEM MODIFICATIONS:     None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 101
______________________________________________________________________________

   9.   00025648   5766 - MODIFICATIONS TO THE CWF COBA CLAIMS SELECTION LOGIC

   REQUESTOR ID: CWFM1000

   IMPACT:
 (X) Host
 (X) Satellite Part A Inpatient
 (X) Satellite Part A Outpatient
 (X) Satellite Part B
 (X) Hospice
 (X) Home Health
 (X) DMERC

   REASON FOR CHANGE:
 Currently, the Common Working File (CWF) system reads the
 COBA Insurance File (COIF) to determine which claim types or
 conditions each COBA Trading Partner wishes to have included
 or excluded from the national COBA crossover process.

 Effective with (5094) CWF modified its logic for adjustment
 claims (Monetary and Non-Monetary) to include a review of
 changes to the deductible, co-insurance and claim reimbursement
 amounts when comparing the original to the adjustment claim.
 At that time CMS did not take into account changes that may
 have been made to the total billed amount on the claim.

 With this instruction, CMS is adding the total billed
 amount as a component for determining changes to adjustment
 claims. CWF has been instructed to in addition to reviewing
 the claim's deductible, co-insurance, and reimbursement
 amount, to review changes that have may have been made to
 the billed amount as part of the matching criteria for
 Disposition Indicator 'H' (Adjusted Claim Monetary) and the
 Disposition Indicator 'I' (Adjusted Claim Non-Monetary).

 Trading Partners have also identified a need to CMS to have
 an 'overarching' adjustment exclusion. This exclusion refers
 to Trading Partner's who do not wish to receive any adjustment
 claims.

 Therefore, with this instruction, CMS is instructing CWF to
 modify the COIF File to include a new exclusion for 'ALL
 ADJUSTMENT CLAIMS'.

 CWF will exclude 'ALL ADJUSTMENT CLAIMS' from crossover, and
 a '29' Trailer will not be generated.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 102
______________________________________________________________________________


 Note: This new logic does not override the existing adjustment
       crossover logic. If an original claim (Action Code '1'
       or Entry Code '1') is submitted and does not crossed over,
       an adjustment claim (Action Code '3' or Entry Code '5')
       submitted on that original claim will also not cross. The
       adjustment claim will continue to receive a Disposition
       Indicator 'R'.

 1/24/08 H. Alligood

       As a result of this request and with CMS approval,
       the 'R' and new 'AC' exclusions will take precedence
       over other exclusions. The 'R' will be the first
       exclusion processed, which would cause the incoming
       adjustment claim to not cross over if the original did
       not cross. This will be followed by the 'AC' logic
       that will exclude all adjustments if the COIF file
       indicator is flagged to bypass all adjustment claims.

   NEW BUSINESS REQUIREMENTS:

 Requirement 1
 CWF must modify the logic for Crossover Disposition Indicator
 'H' (Adjusted Claim Monetary) to determine if any of the
 following fields have been changed. These fields will be
 compared on HUIP, HUOP, HUHH and HUHC records between the
 original claim, Action Code '1' and the adjustment Claim,
 Action Code '3'.

 HUIP record
 -------------
 Value Code 'A1', 'B1', 'C1' (Deductible)
 Value Code '09', '11'       (Co-Insurance)
 Value Code '08', '10'       (LTR)
 Reimbursement Amount
 NEW-Total Charge Amount

 HUOP, HUHH, HUHC record
 -------------
 Value Code 'A1', 'B1', 'C1' (Deductible)
 Value Code 'A2', 'B2', 'C2' (Co-Insurance)
 Reimbursement Amount
 NEW-Total Charge Amount


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 103
______________________________________________________________________________

 Requirement 2
 CWF must modify the logic for Crossover Disposition Indicator
 'H' (Adjusted Claim Monetary) to determine if any of the
 following fields have been changed. These fields will be
 compared on the HUBC and HUDC records between the original
 claim Entry Code '1' and the adjustment claim, Entry Code '5'.

 HUBC record
 -------------
 Deductible Applied
 Co-Insurance
 Provider Reimbursement
 Patient Reimbursement
 NEW-Total Submitted Charge (field 628-631)

 HUDC record
 -------------
 Deductible Applied
 Co-Insurance
 Provider Reimbursement
 Patient Reimbursement
 NEW-Total Submitted Charge (field 628-631)

 Requirement 3
 CWF must modify the logic for Crossover Disposition Indicator
 'I' (Adjusted Claim Non-Monetary) to ensure none of the
 following fields have been changed when an HUIP, HUOP, HUHH
 or HUHC record is submitted. The following fields will be
 compared between the original claim, Action Code '1' and the
 adjustment claim, Action Code '3'.

 HUIP record
 -------------
 Value Code 'A1', 'B1', 'C1' (Deductible)
 Value Code '09', '11'       (Co-Insurance)
 Value Code '08', '10'       (LTR)
 Reimbursement Amount
 NEW-Total Charge Amount

 HUOP, HUHH, HUHC record
 -------------
 Value Code 'A1', 'B1', 'C1' (Deductible)
 Value Code 'A2', 'B2', 'C2' (Co-Insurance)
 Reimbursement Amount
 NEW-Total Charge Amount

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 104
______________________________________________________________________________

 Requirement 4
 CWF must modify the logic for Crossover Disposition Indicator
 'I' (Adjusted Claim Non-Monetary) to ensure none of the
 following fields have been changed when an HUBC or HUDC
 record is submitted. The following fields will be compared
 between the original claim, Entry Code '1' and the adjustment
 claim, Entry Code '5'.

 HUBC record
 -------------
 Deductible Applied
 Co-Insurance
 Provider Reimbursement
 Patient Reimbursement
 NEW-Total Submitted Charge (field 628-631)

 HUDC record
 -------------
 Deductible Applied
 Co-Insurance
 Provider Reimbursement
 Patient Reimbursement
 NEW-Total Submitted Charge (field 628-631)

 Requirement 5
 CWF must re-define filler in location 184, in copybook
 CABECOIF to contain a new 1-byte field for an exclusion
 for 'ADJUSTMENTS'. The valid value for the new field will
 be 'Y'.

 The remaining filler is in location 185-187.

 Requirement 6
 CWF will create a new value for the Crossover Disposition
 Indicator field. The value will be displayed on HUIP,
 HUOP, HUHH and HUHC records. The new value is 'AC' (ALL
 ADJUSTMENT CLAIMS EXCLUDED).

 The new 'AC' indicator will be generated when an incoming
 Part A claim contains an Action Code '3', and the COBA ID
 on the COIF FILE is in the Eligibility File-Based range
 (00001-29999, 30000-54999, 60000-69999, 70000-79999, or 80000-
 89999). The COBA ID has an exclusion marked for 'ALL ADJUSTMENTS'.

 Claims that receive the new 'AC' indicator will not crossover
 and the '29' Trailer will not be generated.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 105
______________________________________________________________________________


Requirement 7
CWF will create a new value for the Crossover Disposition
Indicator field that will be received on incoming HUBC
and HUDC records. The new value is 'AC' (ALL ADJUSTMENT
CLAIMS EXCLUDED).

The new 'AC' indicator will be generated when an incoming
Part B/DMERC claim contains an Entry Code '5', and the COBA
ID on the COIF FILE is in the Eligibility File-Based range
(00001-29999, 30000-54999, 60000-69999, 70000-79999, or 80000-
89999). The COBA ID has an exclusion marked for 'ALL ADJUSTMENTS'.

Claims that receive the new 'AC' indicator will not crossover
and the '29' Trailer will not be generated.

Requirement 8
The new 'AC' indicator will also be generated for a Beneficiary
who has a COIF File with a COBA ID in the Eligibility File-Based
range (00001-29999, 30000-54999, 60000-69999, 70000-79999, or
80000-89999). The COBA ID has an exclusion marked for 'ALL ADJUSTMENTS'.
The incoming Part A claim contains an 'A' in the header
'CLM ADJ' field, and the Action Code is equal to '1'.

Requirement 9
The new 'AC' indicator will also be generated for a Beneficiary
who has a COIF File with a COBA ID in the Eligibility File-Based
range (00001-29999, 30000-54999, 60000-69999, 70000-79999, or
80000-89999). The COBA ID has an exclusion marked for 'ALL ADJUST-
MENTS'. The incoming Part B/DMERC claim contains an 'A' in the
'CLM ADJ' field, and the Entry Code is equal to '1'.

Requirement 10
CWF must modify the 'COBS' screen in HIMR to display the new
exclusion for 'ADJUSTMENTS'. The valid value will be a 'Y'.

COBA                  COBA INSURANCE FILE - INQUIRY
11/01/2007                                              PAGE
 COBA ID:               TIN:                            FILE MAINT DATE:
   NAME:
   ADDR1:
   ADDR2:
   CITY:                              STATE:     ZIP:



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 106
______________________________________________________________________________

 COMMON CLAIM EXCLUSIONS = Y      MASS ADJ: MPFS       OTHER
 NON ASSIGNED:    ORIG EQ100:     ORIG GT100:     DENIED NO LIA:    DENIED
      ADJ MON:    ADJ NONMON:            MSP:         OTHER INS:         NC
      ADJ 100% PAID:                     ADJ 100% DENIED NO ADDTL LIAB:
      ADJ 100% DENIED ADDTL LIAB:        MSP COST AVOIDS:
 ALL CLAIM EXCLUSIONS: PART-A:     PART-B:    DMERC:   ADJUSTMENTS: <<<<
 BILL TYPE EXCLUSIONS:

 11   HOSP INPA     :    12   HOSP INPB :    13   HOSP OUTP     :   14   HOSP OTHER
 18   HOSP SWING    :    21   SNF INPA   :   22   SNF INPB      :   23   SNF OUTP
 24   SNF OTHER B   :    28   SNF SWING :    32   HH PARTB      :   33   HH PARTA
 34   HH OUTP       :    41   REL NON MED:   71   CL RURAL      :   72   CL FREESTA
 73   CL FED HC     :    74   CL OUTP R :    75   CL CORF       :   76   CL COMP MH
 79   CL OTHER      :    81   HOSP NONH :    82   HOSP H        :   83   AMB SURG C
 85   PRI CARE H    :

      CLEAR=EXIT    PF3=RETURN   ENTER=PROCESS    PF8=FWRD

 Requirement 11
 CWF must ensure the new 'AC' Crossover Disposition Indicator
 is displayed on the detail of Page 3 of the INPH, OUTH, HHAH
 and HOSH for Part A records in HIMR.

 Requirement 12
 CWF must ensure the new 'AC' Crossover Disposition Indicator
 is displayed on the detail of Page 2 of the PTBH and DMEH
 record in HIMR.

 Requirement 13 (Internal to CWF only)
 The COIF Update Screen (HCOI) in HIMR must be modified
 to include an entry for 'ADJUSTMENTS'.

 HCOI HCOICOIF        COBA INSURANCE FILE -           INQUIRY MODE
 11/01/2007                                                     PAGE
  COBA ID: 0000000000   TIN:                                    FILE MAINT DATE:
    NAME :
    ADDR1:
    ADDR2:
    CITY:                             STATE:             ZIP:        -

 COMMON CLAIM EXCLUSIONS = Y      MASS ADJ: MPFS      OTHER
 NON ASSIGNED:    ORIG EQ100:     ORIG GT100:    DENIED NO LIA:    DENIED
      ADJ MON:    ADJ NONMON:            MSP:        OTHER INS:         NC
      ADJ 100% PAID:                     ADJ 100% DENIED NO ADDTL LIAB:
      ADJ 100% DENIED ADDTL LIAB:        MSP COST AVOIDS:
 ALL CLAIM EXCLUSIONS: PART A: PART B: DMERC:       ADJUSTMENTS: <<<<<
______________________________________________________________________________
2020 Company, LLC                                           Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 107
______________________________________________________________________________

BILL   TYPE EXCLUSIONS:
  11   HOSP INPA :      12   HOSP INPB :      13   HOSP OUTP   :   14   HOSP OTHER
  18   HOSP SWING :     21   SNF INPA   :     22   SNF INPB    :   23   SNF OUTP
  24   SNF OTHER B:     28   SNF SWING :      32   HH PARTB    :   33   HH PARTA
  34   HH OUTP    :     41   REL NON MED:     71   CL RURAL    :   72   CL FREESTAN
  73   CL FED HC :      74   CL OUTP R :      75   CL CORF     :   76   CL COMP MH
  79   CL OTHER   :     81   HOSP NONH :      82   HOSP H      :   83   AMB SURG CT
  85   PRI CARE H :

 CLEAR=EXIT    PF3=RETURN     ENTER=PROCESS   PF8=FWRD

Requirement 14
CWF must bypass the 'ALL ADJUSTMENTS' logic for incoming
Part B/DMERC claims that have a Medigap Claim-Based COBA
ID range (0000055000 - 0000059999) in the Crossover ID
field '34'.

If there are no exclusions marked on the COIF File for
the Medigap Claim-Based COBA ID these incoming claims
will always crossover.

  EVENT-RESPONSE LIST:

Event 1.1
Enter an HUIP record for a Beneficiary that has an exclusion
marked for 'Adjustment Claims Monetary'. The incoming claim
has an Action Code '3'. The amount in the Total Charge field,
in the '0001' Revenue Code Line has been changed.

Response
The incoming record is processed, and does not crossover. A
'29' Trailer is not generated. An 'H' is displayed on the
Page 3 of the detail of the claim in HIMR.

Event 1.2
Enter an HUOP, HUHH or HUHC record for a Beneficiary that
has an exclusion marked for 'Adjustment Claims Monetary'.
The incoming claim has an Action Code '3'. The amount in the
Total Charge field in the '0001' Revenue Code Line has been
changed.

 Event 2.1
 Enter an HUBC or HUDC record for a Beneficiary that has
 an exclusion marked for 'Adjustment Claims Monetary'.
 The incoming claim has an Entry Code '5'. The amount in
 the Total Submitted field has been changed.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 108
______________________________________________________________________________


 Response
 The incoming record is processed, and does not crossover. A
 '29' Trailer is not generated. An 'H' is displayed on the
 Page 2 of the detail of the claim in HIMR.

 Event 3.1
 Enter an HUIP record for a Beneficiary that has an exclusion
 marked for 'Adjustment Claims Non-Monetary'. The incoming claim
 has an Action Code '3'. The amount in the Total Charge field,
 in the '0001' Revenue Code Line has not been changed.

 Response
 The incoming record is processed, and does not crossover. A
 '29' Trailer is not generated. An 'I' is displayed on the
 Page 3 of the detail of the claim in HIMR.

 Event 3.2
 Enter an HUOP, HUHH or HUHC record for a Beneficiary that
 has an exclusion marked for 'Adjustment Claims Non-Monetary'.
 The incoming claim has an Action Code '3'. The amount in the
 Total Charge field in the '0001' Revenue Code Line has been not
 changed.

 Response
 The incoming record is processed, and does not crossover. A
 '29' Trailer is not generated. An 'I' is displayed on the
 Page 3 of the detail of the claim in HIMR.

 Event 4.1
 Enter an HUBC or HUDC record for a Beneficiary that has
 an exclusion marked for 'Adjustment Claims Non-Monetary'.
 The incoming claim has an Entry Code '5'. The amount in
 the Total Submitted field has been changed.

 Response
 The incoming record is processed, and does not crossover. A
 '29' Trailer is not generated. An 'I' is displayed on the
 Page 2 of the detail of the claim in HIMR.

 Event 5.1
 Review the copybook for CABECOIF.

 Response
 The field has been redefined to display the data for the new
 Crossover Disposition Indicator 'AC'.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 109
______________________________________________________________________________


Event 6.1
Enter an HUIP, HUOP, HUHH or HUHC record for a Beneficiary that
has an exclusion marked for 'ADJUSTMENTS'. The incoming claim
has an Action Code '3'. The COBA ID is in the Eligibility File
range (00001-29999, 30000-54999, 60000-69999, 70000-79999, or
80000-89999). There are no other exclusions on the file.

Response
The incoming record is processed, and does not crossover. A
'29' Trailer is not generated. An 'AC' is displayed on the
Page 3 of the detail of the claim in HIMR.

Event 7.1
Enter an HUBC or HUDC record for a Beneficiary that has an
exclusion marked for 'ADJUSTMENTS'. The incoming claim has
an Entry Code '5'. The COBA ID is in the Eligibility File
range (00001-29999, 30000-54999, 60000-69999, 70000-79999,
or 80000-89999). There are no other exclusions on the file.

Response
The incoming record is processed, and does not crossover. A
'29' Trailer is not generated. An 'AC' is displayed on the
Page 2 of the detail of the claim in HIMR.

Event 8.1
Enter an HUIP, HUOP, or HUHC record for a Beneficiary that
has an exclusion marked for 'ADJUSTMENTS'. The incoming claim
has an Action Code '1'. The 'Claim Adjustment' field in the
header contains an 'A'. The COBA ID is in the Eligibility
file range (00001-29999, 30000-54999, 60000-69999, 70000-79999,
or 80000-89999). There are no other exclusions on the file.

Response
The incoming record is processed, and does not crossover. A
'29' Trailer is not generated. An 'AC' is displayed on the
Page 3 of the detail of the claim in HIMR.

Event 9.1
Enter an HUBC or HUDC record for a Beneficiary that has an
exclusion marked for 'ADJUSTMENTS'. The incoming claim has
an Entry Code '1'. The 'Claim Adjustment' field in the header
contains an 'A'. The COBA ID is in the Eligibility file range
(00001-29999, 30000-54999, 60000-69999, 70000-79999 or 80000-
89999). There are no other exclusions on the file.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 110
______________________________________________________________________________

 Response
 The incoming record is processed, and does not crossover. A
 '29' Trailer is not generated. An 'AC' is displayed on the
 Page 2 of the detail of the claim in HIMR.

 Event 10.1
 Access a COBA ID via the COBS screen in HIMR.

 Response
 A field is displayed on the COIF File for the 'ADJUSTMENTS'
 exclusion.

 Event 11.1
 Access the detail line of the INPL, OUTL, HHAL and HOSL
 screen in HIMR for a Beneficiary that has an adjustment
 posted. The exclusion marked on the COIF file is for
 'ADJUSTMENTS'. The COBA ID is in the (30000-54999) range.

 Response
 Page 3 of the detail of the claim displays the new 'AC'
 Crossover disposition Indicator.

 Event 12.1
 Access the detail line of the PTBL and the DMEL screen
 in HIMR for a Beneficiary that has an adjustment claim
 posted. The exclusion marked on the COIF File is for
 'ADJUSTMENTS'. The COBA ID is in the (30000-54999) range.

 Response
 Page 2 of the detail of the claim displays the new 'AC'
 Crossover disposition Indicator.

 Event 13.1
 Access the HCOI screen in CWF.

 Response
 A new field for the exclusion ADJUSTMENTS is displayed.

 Event 14.1
 Enter an HUBC or HUDC record for a Beneficiary that has an
 exclusion marked for 'ADJUSTMENTS'. The incoming
 claim has an Entry Code '5'. The COBA ID on the claim is in
 the Medigap Claim Based range (55000 - 59999). There are no
 other exclusions on the COBA File.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 111
______________________________________________________________________________

 Response
 The incoming record is processed, and crosses over. A '29'
 Trailer is generated. An 'A' is displayed on Page 2 of the
 detail of the claim in HIMR.

   EDITS AFFECTED:   None

   INSTALLATION INSTRUCTIONS:    None

   SYSTEMS DOCUMENTATION AFFECTED:

    COPYXTNL                RE-DEFINE FIELD 184 FOR 'ALL ADJUSTMENT
                            CLAIMS'.

    OVERHIMR                ADD NEW 'ALL ADJUSTMENT CLAIMS' TO COBS
                            SCREEN.

    OVERINFO                ADD NEW FIELDS FOR 'ALL ADJUSTMENT CLAIMS'.

   SATELLITE SYSTEM MODIFICATIONS:      None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 112
______________________________________________________________________________

   10. 00025649   5764- NEW PATIENT STATUS DISCHARGE CODE 70

   REQUESTOR ID: CWFM2000

   IMPACT:
 (X) Host
 (X) Satellite Part A Inpatient
 (X) Satellite Part A Outpatient
 ( ) Satellite Part B
 ( ) Hospice
 (X) Home Health
 ( ) DMERC

   REASON FOR CHANGE:
 Several members of the National Uniform Billing Committee
 (NUBC) participated in a workgroup to ensure the clarity of
 the definitions of the patient discharge status codes.
 As a result of the meeting NUBC has redefined the patient
 discharge status code '05' to indicate a discharge/transfer
 to a designated cancer center or children's hospital. In
 addition, a new patient discharge status code '70' was created
 in order for providers to be able to indicate discharges/
 transfers to another type of health care institution not
 defined elsewhere in the code list. NUBC will implement both
 of these actions effective 04/01/2008.

 For Inpatient Prospective Payment System (IPPS) hospitals,
 the post-acute transfer payment policy will not apply to
 claims that contain patient discharge status code '70'.

 Field Locator 17 of the UB-04 and its electronic equivalent
 is a required field on all institutional claims. This code
 indicates the disposition or discharge status of the
 Beneficiary on the submitted claim. The NUBC approved patient
 status code '70' and defined it as "discharge/transfer to
 another type of health care institution not defined elsewhere
 in the code list". This code is effective for use by Providers
 for discharge dates on or after 04/01/2008.

   NEW BUSINESS REQUIREMENTS:

 NOTE:
 Medicare systems shall NOT include patient discharge status
 code '70' in the list of codes allowed in a same day transfer
 situation.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 113
______________________________________________________________________________

 Requirement 1
 Modify consistency edit '2101' (Patient Status code omitted or
 code impossible) to include Patient Status '70' (Discharge/
 Transfer to another type of health care institution not
 defined elsewhere in the code list) as a valid Patient Status
 for Hospitals, SNF, Outpatient, and Home Health.

 Requirement 2
 Modify A/B Crossover Alert '7545' (An Inpatient claim, TOB '11x',
 with From and Thru Dates that equal, or overlap, the From and
 Thru Dates, or if present, Occurrence Span Code '72' From and
 Thru Dates, on an Outpatient claim, TOB '12x', '13x', '14x',
 '32x', '33x', '34x', '72x', '73x', '74x', '75x', '76x', or '83x',
 in history) to include Patient Status '70' (Discharge/Transfer
 to another type of health care institution not defined elsewhere
 in the code list) to bypass using same logic as Patient Status
 '05'.

 Requirement 3
 Modify A/B Crossover edit '7272' (Inpatient claim with incorrect
 Patient Status due to transfer to another facility) to include
 Patient Status '70' (Discharge/Transfer to another type of health
 care institution not defined elsewhere in the code list) to set
 when the condition applies.

 Requirement 4
 Modify the '7272' Informational Unsolicited Response (Inpatient
 claim with incorrect Patient Status due to transfer to another
 facility) to include Patient Status '70' (Discharge/Transfer
 to another type of health care institution not defined elsewhere
 in the code list) to set when condition applies.

 Requirement 5
 Modify A/B Crossover edit '729H' (IRF PPS claim improperly
 coded as discharge) to include Patient Status '70' (Discharge/
 Transfer to another type of health care institution not defined
 elsewhere in the code list) to set when the condition applies.

 Requirement 6
 Modify the '729H' Informational Unsolicited Response (IRF
 PPS claim improperly coded as discharge) to include Patient
 Status '70' (Discharge/Transfer to another type of health care
 institution not defined elsewhere in the code list) to set
 when condition applies.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 114
______________________________________________________________________________

   EVENT-RESPONSE LIST:

 Event 1.1
 An HUIP record is received with Patient Status '70'.

 Response
 Consistency edit '2101' is not set.

 Event 1.2
 An HUIP record is received with Patient Status other than
 '01-08', '20', '30', '50', '51', '61', '62', '63', '65',
 '66', '70', '71', or '72'.

 Response
 Consistency edit '2101' is set.

 Event 2.1
 An HUIP Type of Bill '11x' record is received with Patient
 Status '70' and a Thru Date that is equal to the From Date
 (or if present, Occurrence Span Code '72' From Date) on an
 Outpatient record in history with a Type of Bill '13x', '14x',
 '72x', '73x', '74x', '75x', or '76x'.

 Response
 A/B Crossover Alert '7545' is not returned.

 Event 2.2
 An HUIP Type of Bill '11x' record is received with Patient
 Status other than '01', '02', '03', '04', '05', '06', '07',
 '08', '61', '62', '63', '64', '65', '66', '70', '71', or '72'
 and From and Thru Dates that equal, or overlap, the From and
 Thru Date (or if present, Occurrence Span Code '72' From and
 Thru Dates) on an Outpatient record in history with a Type of
 Bill '13x', '14x', '72x', '73x', '74x', '75x', or '76x'.

 Response
 A/B Crossover Alert '7545' is returned.

 Event 3.1
 An HUIP Acute Care Provider record is received with a
 Patient Status '70' and the Discharge Date equals
 the Admit Date of an SNF, LTCH, Psychiatric, Cancer/
 Children's Hospital, IRF, or Home Health in history.

 Response
 A/B Crossover edit '7272' is set.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 115
______________________________________________________________________________


Event 3.2
An HUIP Acute Care Provider record is received with a
Patient Status other than '01', '04', '08', '20', '43',
'50', '51', '61', '64', '66', or '70' and the Discharge
Date equals the Admit Date of an SNF, LTCH, Psychiatric,
Cancer/Children's Hospital, IRF, or Home Health in history.

Response
A/B Crossover edit '7272' is not set.

Event 4.1
An SNF, LTCH, Psychiatric, Cancer/Children's Hospital, IRF,
or Home Health record is received with an Admit Date
that equals the Discharge Date of an Acute Care record
in history with Patient Status '70'.

Response
An Informational Unsolicited Response (7272) is generated on
the Acute Care record.

Event 4.2
An SNF, LTCH, Psychiatric, Cancer/Children's Hospital, IRF,
or Home Health record is received with an Admit Date
that equals the Discharge Date of an Acute Care record
in history with Patient Status other than '01', '04', '08',
'20', '43', '50', '51', '61', '64', '66', or '70'.

Response
An Informational Unsolicited Response (7272) is not generated
on the Acute Care record.

Event 5.1
An HUIP '11x' IRF PPS ('xx3025 - xx3099' or third digit of
'R' or 'T') claim is received with all the following:

- Patient Status Code '01', '05', '06', '07', '08', '20',
  '43', '50', '51', '65', '66', or '70',

- Discharge Date on, or after 04/01/2007,

- Pricer Return Code other than '02', '03', '12', or '13',

- Condition Code '65' not present, and


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 116
______________________________________________________________________________

 - Discharge Date equal to one of the following in history:

   Acute Care hospital - ('xx0001 - xx0999'),

   Swing Bed - ('xxU000 - xxU999', 'xxW000 - xxW999',
   'xxY000 - xxY999', 'xxZ300 - xxZ399'),

   SNF - ('xx5000 - xx6499'),

   LTCH - ('xx2000 - xx2299'), or

   another IRF ('xx3025 - xx3099' or third digit of 'R'
   or 'T').

 Response
 A/B Crossover edit '729H' is set.

 Event 5.2
 An HUIP '11x' IRF PPS ('xx3025 - xx3099' or third digit of
 'R' or 'T') claim is received with all the following:

  - Patient Status Code '02', '03', '61', '62', '63', or
    '64',

  - Discharge Date on, or after 04/01/2007,

  - Pricer Return Code other than '02', '03', '12', or '13',

  - Condition Code '65' not present, and

  - Discharge Date equal to one of the following in history:

   Acute Care hospital - ('xx0001 - xx0999'),

   Swing Bed - ('xxU000 - xxU999', 'xxW000 - xxW999',
               'xxY000 - xxY999', 'xxZ300 - xxZ399'),

   SNF - ('xx5000 - xx6499'),

   LTCH - ('xx2000 - xx2299'), or

   another IRF - ('xx3025 - xx3099' or third digit of
                 'R' or 'T').

 Response
 A/B Crossover edit '729H' is not set.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 117
______________________________________________________________________________


Event 6.1
An Acute Care hospital - ('xx0001 - xx0999'),

Swing Bed - ('xxU000 - xxU999', 'xxW000 - xxW999',
            'xxY000 - xxY999', 'xxZ300 - xxZ399'),

SNF - ('xx5000 - xx6499'),

LTCH - ('xx2000 - xx2299'), or

IRF - ('xx3025 - xx3099' or third digit of 'R' or 'T')

claim is received with an Admit Date equal to another
IRF PPS ('xx3025 - xx3099' or third digit of 'R' or 'T')
Inpatient '11x' TOB in history with the following
conditions:

- Patient Status Code '01', '05', '06', '07', '08', '20',
  '43', '50', '51', '65', '66', or '70',

- Discharge Date on, or after 04/01/2007,

- Pricer Return Code other than '02', '03', '12', or '13',

- Condition Code '65' not present, and

- Discharge Date equal to an incoming:

  Acute Care hospital - ('xx0001 - xx0999'),

  Swing Bed - ('xxU000 - xxU999', 'xxW000 - xxW999',
              'xxY000 - xxY999', 'xxZ300 - xxZ399'),

  SNF - ('xx5000 - xx6499'),

  LTCH - ('xx2000 - xx2299'), or

  another IRF - ('xx3025 - xx3099' or third digit of 'R'
                or 'T').

 Response
 The claim is accepted, and an Informational Unsolicited
 Response is generated for the incorrect Inpatient claim
 with the incorrect Patient Status. A 'T' is displayed in
 the Trailer '24'. Error code '729H' will be displayed in
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 118
______________________________________________________________________________

the Trailer '24'. The claim in history displays a 'T' in
the UNSOL IND field. Trailer '13' will also be returned to
identify the HUIP record causing the Informational
Unsolicited Response to be returned.

Event 6.2
An Acute Care hospital - ('xx0001 - xx0999'),

Swing Bed - ('xxU000 - xxU999', 'xxW000 - xxW999',
            'xxY000 - xxY999', 'xxZ300 - xxZ399'),

SNF - ('xx5000 - xx6499'),

LTCH - ('xx2000 - xx2299'), or

IRF - ('xx3025 - xx3099' or third digit of 'R' or 'T')

claim is received with an Admit Date equal to an IRF PPS
('xx3025 - xx3099' or third digit of 'R' or 'T') Inpatient
'11x' TOB in history with the following conditions:

-Patient Status Code '02', '03', '61', '62', '63', or
'64',

- Discharge Date on, or after 04/01/2007,

- Pricer Return Code other than '02', '03', '12', or '13',

- Condition Code '65' not present, and

- Discharge Date equal to an incoming:

  Acute Care hospital - ('xx0001 - xx0999'),

  Swing Bed - ('xxU000 - xxU999', 'xxW000 - xxW999',
              'xxY000 - xxY999', 'xxZ300 - xxZ399'),

  SNF - ('xx5000 - xx6499'),

  LTCH - ('xx2000 - xx2299'), or

  another IRF - ('xx3025 - xx3099' or third digit of 'R'
                or 'T').



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 119
______________________________________________________________________________

Response
The claim is accepted, and an Informational Unsolicited
Response ('729H') is not generated.

The Entity List includes only NEW acronyms and terminology
that is currently not in use in CWF.

Entity List: N/A

Areas Affected by the Problem.
  1. Consistency Edit
  2. A/B Crossover Edit
  3. Informational Unsolicited Response

Solution Criteria: N/A

  EDITS AFFECTED:

a. Error Code:      2101   ( )New (X)Modified ( )Deleted
Disposition: ER

Type of Record: Hospice, Hospital, SNF

Error Message:
Patient Status code omitted or code impossible.

Set Condition for edit '2101':

Hospital, SNF
When the Patient Status Code is greater than '00' and less
than '09' or the Patient Status Code is equal to '20',
'30', '43', '50', '51', '61', '62', '63', '64', '65', '66',
'70', '71', or '72', bypass this edit.

When the bill type is equal to '185', '215', or '285',
bypass this edit.

When the bill type is equal to '115' and an Inpatient
Condition Code '65' is present, bypass this edit.

If none of the above mentioned bypass criteria are true,
set the '2101' error code.

Hospice
When CANCEL ONLY (Action Code '4') claims, bypass this edit.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 120
______________________________________________________________________________

 When the Transaction Identifier is not equal to 'HUHC' or
 'HIHC', bypass this edit.

 When the Patient Status Code is equal to '30', and the
 third position of the bill type is not equal to 'A', 'B',
 'C', 'D', or 'E', bypass this edit.

 When the Patient Status Code is greater than '00' and less
 than '08', or greater than '39' and less than '43', or
 equal to '61', '62', '63', '64', '65', '70', '71', or '72',
 and the third position of the bill type is not equal to 'A',
 'B', 'C', 'D', or 'E', bypass this edit.

 When the Patient Status Code is equal to '50' or '51',
 bypass this edit.

 Trailer Information: 08


 b. Error Code:    7545    ( )New (X)Modified ( )Deleted
 Disposition: CR

 Type of Record: HHA, Hospital, OUTP

 Error Message:
 An Inpatient claim (TOB '11x') with From and Thru Dates that
 equal, or overlap, the From and Thru Dates (or if present,
 Occurrence Span Code '72' or '74' From and Thru Dates) on an
 Outpatient claim (TOB '12x', '13x', '14x', '32x', '33x',
 '34x', '72x', '73x', '74x', '75x', '76x', or '83x') in
 history.

 Set condition for edit '7545':

 See SYSDEF for details on how WS-HOLD-FROM-DATE, S-FLU-OR-
 PNEUMO-HCPCS-PRESENT, S-CONDITION-CODE-M1-PRESENT, and S-
 MAMMO-REV-HCPC-PRESENT are set.

 If the detail line item Date of Service on the history
 overlaps the From/Thru Dates of the incoming Inpatient, SNF,
 RNHCI claim, set the '7545' error code.

 When the claim is a cost avoid claim, set the '7545' error code.

 When none of the following bypass conditions are true, set
 the '7545' error code.
______________________________________________________________________________
2020 Company, LLC                                           Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 121
______________________________________________________________________________


 Note:   When the term Outpatient is referred to, it
         encompasses the Outpatient, Home Health, and Hospice
         claim types unless otherwise stated.

 When the incoming Inpatient Demonstration Number is equal to
 '31', bypass this edit.

 When the history Outpatient Cancel Date is greater than
 zero, bypass this edit.

 When history Outpatient Action Code is equal to '7', bypass
 this edit.

 When the incoming Inpatient No-Pay Code equals 'B', 'C',
 'N', or 'R', bypass this edit.

 When the history Outpatient bill Source Code is not equal to
 '2' or '3', bypass this edit.

 When the history Outpatient Action Code is equal to '2',
 '4', or '6', and the history Outpatient Transaction Code is
 equal to '6', bypass this edit.

 When the first two positions of the incoming Inpatient bill
 type are not equal to '11', bypass this edit.

 When the history Outpatient bill type is not equal to '12',
 '13', '14', '32x', '33x', '34', '72', '73', '74', '75',
 '76' or '83', bypass this edit.

 When the history Outpatient bill contains an Occurrence Span
 Code '72', and the incoming Inpatient stay From Date is
 greater than Occurrence Span Code Thru Date, or the incoming
 Inpatient stay Thru Date is less than the Occurrence Span
 Code From Date, bypass this edit.

 When the Inpatient Stay From Date is greater than history
 Outpatient claim service Thru Date, or the Inpatient stay
 Thru Date is less than the history Outpatient service From
 Date, bypass this edit.

 When S-FLU-OR-PNEUMO-HCPC-PRESENT (and these are the only
 HCPCS present on the bill), and S-CONDITION-CODE-M1-PRESENT,
 bypass this edit.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 122
______________________________________________________________________________

 When S-MAMMO-REV-HCPC-PRESENT (76083, 76092, G0202, G0203)
 and these are the only HCPCS present on the bill), and the
 first two positions of the history Outpatient bill type are
 equal to '14' ('13' and Date of Service on or after
 04/01/2005), bypass this edit.

 When S-MAMMO-REV-HCPC-PRESENT (77057 and this is the only
 HCPCS present on the bill), and the Date of Service is on or
 after 01/01/2007, and the first two positions of the history
 Outpatient bill type are '13', bypass this edit.

 When S-PAPSM-REV-HCPC-PRESENT (P3000, G0123, G0143, G0144,
 G0147, or G0148) and these are the only HCPCS present on
 the bill), and the first two positions of the history
 Outpatient bill type are equal to '12' and the Date of
 Service is on or after 07/01/2006, bypass this edit.

 When S-Q0091-REV-HCPC-PRESENT (Q0091) and this is the
 only HCPCS present on the bill), and the first two
 positions of the history Outpatient bill type are equal
 to '12' and the Date of Service is on or after 07/01/2006,
 bypass this edit.

 When S-G0101-REV-HCPC-PRESENT (G0101) and this is the
 only HCPCS present on the bill), and the first two
 positions of the history Outpatient bill type are equal
 to '12' and the Date of Service is on or after 07/01/2006,
 bypass this edit.

 When the first two positions of the history Outpatient bill
 type are equal '12', and the incoming Inpatient Provider
 Number is equal to the history Outpatient Provider Number,
 and the incoming Inpatient bill has an Occurrence Code of
 'A3', 'B3', or 'C3';

      When the history Outpatient bill contains an
      Occurrence Span Code '72', and the Occurrence Span
      Code From Date is greater than the Occurrence Span
      Code Date,

      OR

      When the history Outpatient Service From Date is
      greater than the Occurrence Span Code Date, bypass
      this edit.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 123
______________________________________________________________________________

 When the first two positions of the history Outpatient bill
 type are equal to '12' and the incoming Inpatient bill has
 an Occurrence Span Code '74';

     When the history Outpatient bill contains an
     Occurrence Span Code '72', and when the Occurrence
     Span Code '72' From Date is greater than zero, and it
     is greater than or equal to the Occurrence Span Code
     '74' From Date, and the Occurrence Span Code '72' Thru
     Date is less than, or equal to the Occurrence Span
     Code '74' Thru Date,

     OR

     When the history Outpatient Service From Date is
     greater than or equal to the Occurrence Span Code '74'
     From Date, and the history Outpatient Service Thru
     Date is less than, or equal to, the Occurrence Span
     Code '74' Thru Date, bypass this edit.

 When the first two positions of the history Outpatient bill
 type equals '73', and the incoming Inpatient non-covered
 days are greater than zero, and the Inpatient claim has a
 Condition Code '65' present, bypass this edit.

 When the first two positions of the history Outpatient bill
 type are equal to '13', and the only Revenue Code on the
 history Outpatient bill is '054x';

    When the history Outpatient bill has an Occurrence Span
    Code '72', and the Occurrence Span Code From Date is
    equal to the incoming Inpatient Admission Date, or the
    Occurrence Span Code Thru Date is equal to the
    incoming Inpatient Stay Thru Date,

    OR

    When the history Outpatient Service Thru Date is equal
    to either the Inpatient Admission Date or Inpatient
    Stay Thru Date, bypass this edit.

 When the first two positions of the history Outpatient bill
 type are '32x', '33x', or '34', and the only Revenue Code on
 the history Outpatient bill is a '0274', '029x', or '060x',
 bypass this edit.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 124
______________________________________________________________________________

 When the first two positions of the history Outpatient bill
 type are equal to '12', '13', '14', '72', '73', '74', '75',
 or '76', and incoming Inpatient Patient Status Code is equal
 to '01', '02', '03', '04', '05', '06', '07', '08', '61',
 62','63', '64', '65', '66', '70', '71', or '72';

    When the incoming Inpatient bill contains an Occurrence
    Span Code of '74', '76', '77', or '79';

    When the history Outpatient bill contains an Occurrence
    Span Code '72';

    When the Occurrence Span Code '72' From Date is
    greater than, or equal to, the incoming Inpatient
    Occurrence Span Code From Date, and the Occurrence
    Span Code '72' Thru Date is less than, or equal to,
    the incoming Inpatient Occurrence Span Code Thru Date,

 When the Occurrence Span Code '72' From Date is greater
 than, or equal to, the incoming Inpatient Occurrence Span
 Code From Date, and the Occurrence Span Code '72' Thru Date
 is equal to the incoming Inpatient Stay Thru Date, and the
 incoming Inpatient Stay Thru Date minus the incoming
 Inpatient Occurrence Span Code Thru Date is equal to '1',
 bypass this edit.

 When the history Outpatient Service From Date is greater
 than, or equal, to the incoming Inpatient Occurrence Span
 Code From Date, and the history Outpatient Service Thru Date
 is equal to the incoming Inpatient Stay Thru Date, and the
 incoming Inpatient Stay Thru Date minus the incoming
 Inpatient Occurrence Span Code Thru Date is equal to '1',
 bypass this edit.

 When the history Outpatient Service From Date is greater
 than, or equal to, the incoming Inpatient Occurrence Span
 Code From Date, and the history Outpatient Service Thru Date
 is less than, or equal to, the incoming Inpatient Occurrence
 Span Code Thru Date, bypass this edit.

 When the history Outpatient bill contains an Occurrence Span
 Code '72', and the Occurrence Span Code '72' From Date is
 greater than, or equal to, the incoming Inpatient Occurrence
 Span Code From Date, and the Occurrence Span Code '72' Thru
 Date is equal to the incoming Inpatient stay Thru Date, and
 the incoming Inpatient stay Thru Date minus the incoming
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 125
______________________________________________________________________________

 Inpatient Occurrence Span Code Thru Date is equal to '1',
 bypass this edit.

 When the history Outpatient service From Date is greater
 than, or equal to, the incoming Inpatient Occurrence Span
 Code From Date, and the history Outpatient service Thru Date
 is equal to the incoming Inpatient stay Thru Date, and the
 incoming Inpatient stay Thru Date minus the incoming
 Inpatient Occurrence Span Code Thru Date is equal to '1',
 bypass this edit.

 When the history Outpatient bill contains an Occurrence Span
 Code '74', and when the incoming Inpatient stay From Date is
 less than the history Outpatient Occurrence Span Code '74'
 From Date, or the incoming Inpatient stay Thru Date is
 greater than the history Outpatient Occurrence Span Code
 '74' Thru Date, bypass this edit.

 When the incoming Inpatient patient status equal '01', '02',
 '03', '04', '05', '06', '07', '08', '61', '62', '63',
 '64', '65', '66', '70', '71', or '72';

     When the history Outpatient bill does not contain an
     Occurrence Span Code '72', and the incoming Inpatient
     stay Thru Date is equal to the history Outpatient
     service From Date, bypass this edit.

 When the history Outpatient bill contains an Occurrence Span
 Code '72', and the incoming Inpatient stay Thru Date equals
 the Occurrence Span Code From Date, bypass this edit.

 An Inpatient claim is submitted (bill type '11x', '21x', or
 '41x' with From/Thru Dates that overlap the detail line item
 Date of Service of a Home Health claims (bill type '32x',
 '33x', or '34x') on the history with Dates of Service on, or
 after, 10/01/2000;

     The detail line item date equals the Admit Date on
     the Hospital Inpatient, RNHCI or SNF claim in
     history, bypass this edit.

 The detail line item date equals the Thru Date on the
 Hospital Inpatient, SNF, or RNHCI claim if the Patient
 Status is not '30' in history, bypass this edit.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 126
______________________________________________________________________________

 The detail line item date equals the non-covered period
 Occurrence Span Code '74' Dates on an Inpatient, SNF, or
 RNHCI claim in history, bypass this edit.

 The SNF claim has a 'N' Non-payment Code present, bypass
 this edit.

 When the incoming Inpatient claim is an IME/GME with
 Condition Codes '04', and '69' and the History Outpatient
 claim is an Encounter, bypass this edit.

 When HCPCS code is equal to 'G9017', 'G9018', 'G9019',
 'G9020', 'G9033', 'G9034', 'G9035', or 'G9036', bypass this
 edit.

 When the incoming Inpatient claim (TOB 11x) and the
 Outpatient history claim (TOB 72x) and Dates of Service on
 or after 04/01/2007, bypass this edit.

 Trailer Information: '13'


 c. Error Code:    7272   ( )New (X)Modified ( )Deleted
 Disposition: CR

 Type of Record:   Hospital

 Error Message:
 Inpatient claim with incorrect Patient Status due to transfer to
 another facility.

 Set Condition for edit '7272':

 When incoming Inpatient claim is a bill type of '11x' and
 has Provider Number equals 'XX0001-XX0999' and patient
 status equals (01, 04, 08, 20, 43, 50, 51, 61, 64, 66, or 70)
 and have one of these post acute DRG codes:

 With Discharge Date prior to 10/01/2004:
 '012', '014', '024', '025', '088', '089', '090', '113',
 '121', '122', '127', '130', '131', '209', '210', '211',
 '236', '239', '277', '278', '294', '296', '297', '320',
 '321', '395', '429', '468', '483'.



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 127
______________________________________________________________________________

 With Discharge Date after 09/30/2004:
 '012', '014', '024', '025', '088', '089', '090', '113', '121',
 '122', '127', '130', '131', '209', '210', '211', '236',
 '239', '277', '278', '294', '296', '297', '320', '321',
 '395', '429', '468', '483', '541', or '542'.

 With Discharge Date on or after 10/01/2005:
 '1', '2', '7', '8', '10', '11', '12', '13', '14', '15', '16',
 '17', '18', '19', '20', '24', '25', '28', '29', '34', '35',
 '73', '75', '76', '77', '78', '79', '80', '82', '83', '84', '85',
 '86', '89', '90', '92', '93', '101', '102', '104', '105', '108',
 '113', '114', '120', '121', '126', '127', '130', '131', '144',
 '145', '146', '147', '148', '149', '150', '151', '154', '155',
 '157', '158', '170', '171', '172', '173', '176', '180', '181',
 '188', '189', '191', '192', '197', '198', '205', '206', '210',
 '211', '213', '216', '217', '218', '219', '225', '226',
 '227', '233', '234', '235', '236', '238', '239', '240', '241',
 '244', '245', '250', '251', '253', '254', '256', '263', '264',
 '265', '266', '269', '270', '271', '272', '273', '277', '278',
 '280', '281', '283', '284', '285', '287', '292', '293', '294',
 '296', '297', '300', '301', '304', '305', '316', '320', '321',
 '331', '332', '395', '401', '402', '403', '404', '415', '416',
 '418', '423', '429', '430', '440', '442', '443', '444', '445',
 '462', '463', '464', '468', '471', '475', '477', '482', '485',
 '487', '497', '498', '501', '502', '521', '522', '529', '530',
 '532', '537', '538', '541', '542', '543', '544', '545',
 '547', '548', '549', '550', '553', '554'.

        (Effective for Discharge Date on or after 10/01/2006)

 '1', '2', '7', '8', '10', '11', '12', '13', '14', '15', '16',
 '17', '18', '19', '28', '29', '34', '35', '73', '75', '76', '77',
 '78', '79', '80', '82', '83', '84', '85', '86', '89', '90', '92',
 '93', '101', '102', '104', '105', '108', '113', '114', '120',
 '121', '126', '127', '130', '131', '144', '145', '146', '147',
 '149', '150', '151', '155', '157', '158', '170', '171', '172',
 '173', '176', '180', '181', '188', '189', '191', '192', '197',
 '198', '205', '206', '210', '211', '213', '216', '217', '218',
 '219', '225', '226', '227', '233', '234', '235', '236', '238',
 '239', '240', '241', '244', '245', '250', '251', '253', '254',
 '256', '263', '264', '265', '266', '269', '270', '271', '272',
 '273', '277', '278', '280', '281', '283', '284', '285', '287',
 '292', '293', '294', '296', '297', '300', '301', '304', '305',
 '316', '320', '321', '331', '332', '395', '398', '399', '401',
 '402', '403', '404', '418', '423', '429', '430', '440', '442',
 '443', '444', '445', '462', '463', '464', '468', '471', '477',
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 128
______________________________________________________________________________

 '482',   '485',   '487', '497',   '498',   '501',   '502',   '521',   '522',
 '529',   '530',   '532', '537',   '538',   '541',   '542',   '543',   '544',
 '545',   '547',   '548', '549',   '550',   '553',   '554',   '562',   '563',
 '565',   '566',   '567', '568',   '569',   '570',   '572',   '573',   '575',
 '576',   '578',   and '579'.

      (Effective for Discharge Date on or after 10/01/2007)

 '003','004','025','026','027','028','029','030','031','032',
 '033','040','041','042','054','055','056','057','064','065',
 '066','070','071','072','085','086','087','091','092','093',
 '100','101','163','164','165','166','167','168','175','176',
 '177','178','179','186','187','188','190','191','192','193',
 '194','195','196','197','198','205','206','207','216','217',
 '218','219','220','221','228','229','230','233','234','235',
 '236','239','240','241','242','243','244','255','256','257',
 '264','280','281','282','288','289','290','291','292','293',
 '299','300','301','314','315','316','326','327','328','329',
 '330','331','332','333','334','335','336','337','356','357',
 '358','371','372','373','374','375','376','377','378','379',
 '380','381','382','388','389','390','405','406','407','414',
 '415','416','441','442','443','459','460','463','464','465',
 '466','467','468','469','470','474','475','476','477','478',
 '479','480','481','482','483','484','488','489','492','493',
 '494','495','496','497','500','501','502','510','511','512',
 '515','516','517','533','534','535','536','539','540','541',
 '542','543','544','545','546','547','551','552','557','558',
 '559','560','561','562','563','573','574','575','579','580',
 '581','592','593','594','602','603','616','617','618','622',
 '623','624','628','629','630','637','638','639','640','641',
 '643','644','645','653','654','655','659','660','661','682',
 '683','684','689','690','698','699','700','840','841','842',
 '853','854','855','856','857','858','862','863','867','868',
 '869','870','871','872','884','896','897','907','908','909',
 '917','918','945','946','947','948','956','981','982','983',
 '987','988','989'.

 -     If history claim bill type is '21x' and history claim
       Provider range is (xx5000 - xx6499), and incoming
       claim Discharge Date equals history claim Admit Date.

 OR

 -    If history claim bill type is '11x' and history claim
      Provider is psychiatric (range XX4XXX and XXSXXX) and
      incoming claim Discharge Date equals the history claim
______________________________________________________________________________
2020 Company, LLC                                           Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 129
______________________________________________________________________________

       Admit Date.

 OR

 -     If history claim bill type is '11x' and history claim
       Provider is Children's hospital or Cancer Hospital
       (XX3300 - XX3399) and incoming claim Discharge Date
       equals the history claim Admit Date.

 OR

 -     If history claim bill type is '11x' and history claim
       Provider is IRF (XX3025 - XX3399, XXTXXX, XXRXXX,
       XXMXXX) and incoming claim Discharge Date equals the
       history claim Admit Date.

 OR

 -     If history claim bill type is '11x' and history claim
       Provider is LTCH (XX2000 - XX2299) and incoming claim
       Discharge Date equals the history claim Admit Date,
       set the '7272' error code.

 OR

 -     If history claim bill type is '11X' and history claim
       Provider is Cancer Hospital (Provider Number '100271',
       '100079', '360242', '500138', '050146', '050660',
       '220162', '33154', '330354', '390196', '450076'

 AND

 -     If HH history claim bill type is '32x' or '33x' and
       history claim Provider is Home Health (XX3100-XX3199,
       XX7000-XX8499, or XX9000-XX9499) and the incoming
       Inpatient claims Discharge Date is equal to or within
       3 days of the HH history claim Admit Date, set the '7272'
       error code.

 When No-Pay code 'N' is present on history or incoming
 claim, bypass this edit.

 When incoming claim has Action Code '7', bypass this edit.

 When incoming claim has Condition Code '65', bypass this
 edit.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 130
______________________________________________________________________________


When incoming claim has bill type '11Z', bypass this edit.

When incoming claim has IPPS PRICER-RETURN-CODE is equal to
'16' or '14', bypass this edit.

When the incoming claim's Provider Number is equal to
(Maryland Providers) '210001-210099', '212005', or '212007',
bypass this edit.

Trailer Information: 08, 13


d. Error Code:    729H   ( )New (X)Modified ( )Deleted
Disposition: CR

Type of Record:   Hospital

Error Message:
IRF PPS claim improperly coded as discharge.

Set Condition for edit '729H':

When all the following conditions are met:

When incoming Inpatient claim is a bill type of '11x' and
incoming claim is IRF. Provider range is 'xx3025 - xx3099'
or third position of Medicare Provider Number is 'R' or 'T'.

With patient status equal to (01, 05, 06, 07, 08, 20, 43,
50, 51, 65, 66, or 70).

With incoming claim discharge date on or after 04/01/2007.

-    If history claim is Acute Care Hospital. Provider range
     is (xx0001 - xx0099)

OR

-    If history claim is Swing Bed. Provider range is
     (xxU000 - xxU999, xxW000 - xxW999, xxY000 - xxY999,
      xxZ300 - xxZ399)

OR


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 131
______________________________________________________________________________

 -      If history claim is SNF. Provider range is
        (xx5000 - xx6499)

 OR

 -      If history claim is LTCH. Provider range is
        (xx2000 - xx2299)

 OR

 -      If history claim is another IRF. Provider range is
        (xx3025 - xx3099) or Medicare Provider Number is
        'R' or 'T'.

 When history claim Admission Date equals the incoming
 claim Discharge Date, set the '729H' error code.

 When No-Pay code of 'B' or 'N' is present on history
 or incoming claim, bypass this edit.

 When incoming claim has Condition Code '65',
 bypass this edit.

 When incoming claim has an IPPS PRICER-RETURN-CODE
 equal to '02', '03', '12', or '13', bypass this edit.

 Trailer Information: 08, 13

      INSTALLATION INSTRUCTIONS:   None

      SYSTEMS DOCUMENTATION AFFECTED:

       EDITCONS              MODIFY EDIT '2101' TO INCLUDE
                             PATIENT STATUS CODE '70'.

       EDITABX               MODIFY EDIT '7545' TO INCLUDE
                             PATIENT STATUS CODE '70'.

       EDITABX               MODIFY EDIT '7272' TO INCLUDE
                             PATIENT STATUS CODE '70'.

       EDITABX               MODIFY EDIT '729H' TO INCLUDE
                             PATIENT STATUS CODE '70'.



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 132
______________________________________________________________________________

    DESCLVL2              MODIFY INFORMATIONAL UNSOLICITED RESPONSE
                          LOGIC FOR THE '7272' PROCESS TO INCLUDE
                          PATIENT STATUS CODE '70'.

   SATELLITE SYSTEM MODIFICATIONS:   None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 133
______________________________________________________________________________

   11. 00025651   5777- UPDATE POS CODE FOR TEMPORARY LODGING

   REQUESTOR ID: CWFM2000

   IMPACT:
 (X) Host
 ( ) Satellite Part A Inpatient
 ( ) Satellite Part A Outpatient
 (X) Satellite Part B
 ( ) Hospice
 ( ) Home Health
 (X) DMERC

   REASON FOR CHANGE:
 This CR will update the current POS code set to add a new
 code '16', for temporary lodging and will implement the
 systems and local-contractor-level changes needed for Medicare
 to adjudicate claims with the new code. Local contractors shall
 develop policies as needed to adjudicate claims containing
 this new code.

 CWF shall modify consistency edit '77x1' (Invalid Place of
 Service) to allow POS '16' for HUBC and HUDC.

 CWF shall modify Maintenance edit 'C029' (Invalid Patient
 Residence) to allow POS '16' for HUCM.

 CWF shall modify consistency edit '77x3' (Physician Specialty '65'
 performing Service Type '9' or 'A' must be performed at Place of
 Service) to allow POS '16' for HUBC and HUDC.

 CWF shall modify utilization edit '5507' (Place of Service is
 other than the Beneficiary's residence) to allow POS '16 for
 HUDC.

   NEW BUSINESS REQUIREMENTS:

 Requirement 1
 CWF must modify consistency edit '77x1' (Invalid Place of Service)
 to allow the new POS '16' for temporary lodging for HUBC and HUDC.

 Requirement 2
 CWF must modify CMN maintenance edit 'C029' (Invalid Patient
 Residence) to allow the new POS '16' for temporary lodging for HUCM.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 134
______________________________________________________________________________

 Requirement 3
 CWF must modify Consistency edit '77x3' (Physician '65' performing
 Service Type '9' or 'A' must be performed at Place of Service)
 to allow the new POS '16' for temporary lodging for HUBC and HUDC.

 Requirement 4
 CWF must modify Utilization edit '5507' (Place of Service is other
 than the Beneficiary's residence) to allow POS '16' for HUDC.

   EVENT-RESPONSE LIST:

 Event 1.1
 Submit an HUBC/HUDC record using new POS '16'.

 Response
 The record is accepted and consistency edit '77x1' does not set.

 Event 2.1
 Perform an HUCM transaction using new POS '16' in the residence
 field.

 Response
 The transaction is accepted and edit 'C029' does not set.

 The Entity List includes only NEW acronyms and terminology
 that is currently not in use in CWF.

 Entity List: N/A

 Areas Affected by the Problem.
   1. Consistency Module
   2. DME Maintenance

 Solution Criteria: N/A

   EDITS AFFECTED:

 a. Error Code:      77x1   ( )New (X)Modified ( )Deleted
 Disposition: ER

 Type of Record: Pt. B Carrier

 Error Message:
 Invalid Place of Service.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 135
______________________________________________________________________________

 Set Condition for edit '77x1':
 When the Place of Service is not equal to:
 '01' Pharmacy
 '03' School
 '04' Homeless Shelter
 '05' Indian Health Service Free-standing Facility
 '06' Indian Health Service Provider-based Facility
 '07' Tribal 638 Free-standing Facility
 '08' Tribal 638 Provider-based Facility
 '09' Prison/Correctional Facility
 '11' Office
 '12' Home
 '13' Assisted Living Facility
 '14' Group Home
 '15' Mobile Unit
 '16' Temporary Lodging
 '20' Outpatient
 '21' Inpatient Hospital
 '22' Outpatient Hospital
 '23' Emergency Room Hospital
 '24' Ambulatory Surgical Center
 '25' Birthing Center
 '26' Military Treatment Center
 '31' Skilled Nursing Facility
 '32' Nursing Facility
 '33' Custodial Care Facility
 '34' Hospice
 '41' Ambulance - Land
 '42' Ambulance - Air or Water 1
 '49' Independent Clinic
 '50' Federally Qualified Health Center
 '51' Inpatient Psychiatric Facility
 '52' Psychiatric Facility Partial Hospitalization
 '53' Community Mental Health Center
 '54' Intermediate Care Facility/Mentally Retarded
 '55' Substance Abuse Treatment Facility
 '56' Psychiatric Treatment Facility
 '57' Non-residential Substance Abuse Treatment Facility
 '60' Mass Immunization Center
 '61' Comprehensive Inpatient Rehabilitation Facility
 '62' Comprehensive Outpatient Rehabilitation Facility
 '65' End Stage Renal Disease Treatment
 '71' Public Health Clinic
 '72' Rural Health Clinic
 '81' Independent Laboratory
 '99' Other Unlisted Facility, set the '77x1' error code.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 136
______________________________________________________________________________


When the Payment Process Indicator is equal to 'I', bypass
this edit.

When the Payment Process Indicator is equal to 'O', bypass
this edit.

Trailer Information: 08


b. Error Code: C029       ( )New (X)Modified ( )Deleted
Disposition: CMN

Type of Record: CMN

Error Message:
Invalid Patient Residence.

Set Condition for edit 'C029':

When   the CMN patient residence is not equal to
'01'   Pharmacy
'04'   Homeless Shelter
'09'   Prison/Correctional Facility
'12'   Home
'13'   Assisted Living Facility
'14'   Group Home
'16'   Temporary Lodging
'31'   Skilled Nursing Facility
'32'   Nursing Facility
'33'   Custodial Care Facility
'34'   Hospice
'54'   Intermediate Care Facility/Mentally Retarded
'55'   Substance Abuse Treatment Facility
'56'   Psychiatric Treatment Facility, or
'61'   Comprehensive Inpatient Rehabilitation Facility

and the CMN DMEPOS category is not equal to '7', and the CMN
patient residence is not equal to '21', set the 'C029' error
code.

When the CMN transaction type is equal to '3', bypass this
edit.



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 137
______________________________________________________________________________

 c. Error Code: 77x3    ( )New (X)Modified ( )Deleted
 Disposition: CMN

 Type of Record: Pt. B Carrier

 Error Message:
 Physician Specialty '65' (Physical Therapy) performing
 Service Type '9' (Other Medical) or 'A' (Used DME) must be
 performed at Place of Service.

 Set Condition for edit '77x3':
 When the Provider Specialty is equal to '65', and the Type
 of Service is equal to '9' or 'A', and the Place of Service
 is not equal to
 '03' School
 '04' Homeless Shelter
 '05' Indian Health Service Free-standing facility
 '06' Indian Health Service Provider-based facility
 '07' Tribal '638' Freestanding Facility
 '08' Tribal '638' Provider-based Facility
 '11' Office
 '12' Home
 '13' Assisted Living Facility
 '14' Group Home
 '15' Mobile Unit
 '16' Temporary Lodging
 '20' Outpatient Hospital
 '25' Birthing Center
 '26' Military Treatment Center
 '32' Nursing Facility
 '33' Custodial Care Facility
 '49' Independent Clinic
 '54' Intermediate Care Facility/Mentally Retarded
 '55' Substance Abuse Treatment Facility
 '56' Psychiatric Treatment Facility
 '57' Non-residential Substance Abuse Treatment Facility
 '71' Public Health Clinic
 '72' Rural Health Clinic, set the '77x3' error code.

 When the claim or line item is denied, bypass this edit.

 When the From Date is equal to zeros, or the Payment
 Process Indicator is equal to 'I', bypass this edit.

 When the Type of Service is equal to 'W', bypass this edit.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 138
______________________________________________________________________________

Trailer Information: 08


d. Error Code: 5507       ( )New (X)Modified ( )Deleted
Disposition: CMN

Type of Record: DMEPOS

Error Message:
Place of Service is other than the Beneficiary's residence.

Set Condition for edit '5507':

When the claim line item Place of Service is not equal to
04 - Homeless Shelter
12 - Home
13 - Assisted Living Facility
14 - Group Home
16 - Temporary Lodging
31 - Skilled Nursing Facility
32 - Nursing Facility
33 - Custodial Care Facility
54 - Intermediate Care Facility/Mentally Retarded, set the
'5507' error code.

When the claim ESRD Action Code is equal to 'C' or 'U',
bypass this edit.

Trailer Information: 08

  INSTALLATION INSTRUCTIONS:     None

  SYSTEMS DOCUMENTATION AFFECTED:

    EDITCONS               MODIFY EDIT '77X1' TO INCLUDE POS '16'.

    EDITMNTS               MODIFY EDIT 'C029' TO INCLUDE POS '16'.

    EDITCONS               MODIFY EDIT '77X3' TO INCLUDE POS '16'.

    EDITUTIL                MODIFY EDIT '5507' TO INCLUDE POS '16'.

  SATELLITE SYSTEM MODIFICATIONS:       None



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 139
______________________________________________________________________________

   12. 00025652   5768-IMPLEMENT MONTHLY BILL FOR RDF AND IUR ON OVERLAP INPA

   REQUESTOR ID: CWFM2000

   IMPACT:
 (X) Host
 (X) Satellite Part A Inpatient
 (X) Satellite Part A Outpatient
 ( ) Satellite Part B
 ( ) Hospice
 ( ) Home Health
 ( ) DMERC

   REASON FOR CHANGE:
 CWF shall generate an informational unsolicited response to
 the Intermediary when the Renal Dialysis Facility (RDF) claim
 (ESRD) (72x) is received prior to the hospital Inpatient Part
 A claim (11x). The detail line item Date of Service of the
 RDF claim (72x) is within the Admission and Discharge Date
 of the Inpatient claim (11x) or the detail line item Date
 of Service of the RDF claim (72x) is within the From and Thru
 Date of the Inpatient Part B claim (12x).

   NEW BUSINESS REQUIREMENTS:

 Requirement 1
 CWF will create an informational unsolicited response (IUR)
 for A/B Crossover edit '729C' when an incoming Inpatient
 Part A claim (11x) is processed with disposition '01'.

 Posted to history is an RDF claim (72x) (ESRD) with Dates of
 Service on, or after 04/01/2008. The detail line item Date
 of Service is within the Admission and Discharge Date of
 the incoming Inpatient Part A claim (11x).

    CWF will create an Informational Unsolicited Response
    with Trailer '24' that identifies the RDF claim (72x).

    The Trailer '24' will return a Trailer mask of 'K'
    (RDF claim).

    The Trailer '43' will be returned and identify the
    detail line item and HCPCS/Revenue Code that caused
    the claim to generate an informational unsolicited
    response.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 140
______________________________________________________________________________

    The value for the Trailer mask will be a '0' or '1'.
    If no Trailer '43' was generated the value will be '0'.
    If Trailer '43' is generated the value will be '1'.

    The Informational Unsolicited Indicator code will be
    an 'I'.

CWF will not generate an Informational unsolicited response
when the:

    Incoming Inpatient Part A claim (11x) is submitted
    with Action Code '4' (cancel).

    Incoming Inpatient Part A claim (11x) is submitted
    with No-Pay Code 'N'.

    The detail Edit Override Table has '729C' present.

    History RDF claim detail line item Date of Service
    equals the Inpatient Part A (11x) Admission Date.

    History RDF claim detail line item Date of Service
    equals the Inpatient Part A (11x) Discharge Date and
    the Patient Status is other than '30'.

    History RDF claim Action Code equals '4' (cancel).

    History RDF claim Action Code equals '7' (add history).

    History RDF claim No-Pay Code equals 'N'.

    History RDF claim No-Pay Code 'N' is not present, but
    the Total Charge equals the Non-Covered Charge for the
    detail line item that is within the Inpatient Part A
    claim (11x).

Requirement 2
CWF will create an informational unsolicited response (IUR)
for A/B Crossover edit '729I' when an incoming Inpatient
Part B claim (12x) is processed with disposition '01'.

Posted to history is an RDF claim (72x) (HUOP) with Date
of Service on, or after 04/01/2008. The detail line item
Date of Service is within the From and Thru Date of the
incoming Inpatient Part B claim (12x).

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2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 141
______________________________________________________________________________

    CWF will create an Informational Unsolicited Response
    with Trailer '24' that identifies the RDF claim (72x).

    The Trailer '24' will return a Trailer mask of 'K'
    (RDF claim).

    The Trailer '43' will be returned and identify the
    detail line item and HCPCS/Revenue code that caused the
    claim to generate an informational unsolicited response.

    The value for the Trailer mask will be a '0' or '1'.
    If no Trailer '43' was generated the value will be '0'.
    If Trailer '43' is generated the value will be '1'.

    The Informational Unsolicited Indicator code will be
    an 'I'.

CWF will not generate an Informational Unsolicited Response
when the:

    Incoming Inpatient Part B claim (12x) is submitted with
    Action Code '4' (cancel).

    Incoming Inpatient Part B claim (12x) is submitted with
    Action Code '7' (add to history).

    Incoming Inpatient Part B claim (12x) is submitted with
    No-Pay Code 'N'.

    The detail Edit Override Table has '729I' present.

    History RDF claim detail line item Date of Service
    equals the Inpatient Part B claim (12x) From Date.

    History RDF claim detail line item Date of Service
    equals the Inpatient Part B claim (12x) Thru Date.

    History RDF claim (72x) Cancel Date is greater than
    zero.

    History RDF claim (72x) Action Code equals '7' (add to
    history).

    History RDF claim (72x) has a No-Pay Code equal to 'N'.


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2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 142
______________________________________________________________________________

    History RDF claim is without a No-Pay Code 'N', but
    the Total Charge equals the Non-Covered Charge for the
    detail line item that is within From and Thru Date of
    incoming Inpatient Part B claim (12x).

 Requirement 3
 CWF must modify A/B Crossover edit '729I' to read the
 From and Thru Date of the posted Inpatient Part B claim
 (12x) in history when an incoming RDF claim (72x) is received.
 The RDF claim (72x) has a detail line item Date of Service
 that is within the From and Thru Date of the posted
 Inpatient Part B claim (12x) in history.

 Bypass the incoming RDF claim (72x) when the detail line
 item Date of Service equals the Inpatient Part B claim
 (12x) From Date.

 Bypass the incoming RDF claim (72x) when the detail line
 item Date of Service equals the Inpatient Part B claim
 (12x) Thru Date.

 Bypass the incoming RDF claim (72x) when it is submitted
 without a No-Pay Code 'N', but the Total Charge equals
 the Non-Covered Charge for the detail line item Date of
 Service that is within the From and Thru Date of the
 Inpatient Part B claim.

 Note: This is an addition to the existing bypass logic.

   EVENT-RESPONSE LIST:

 Event 1.1
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008.

 An incoming Inpatient Part A claim (11x) is received. The
 posted RDF claim detail line item Date of Service is within
 the Admission and Discharge Date of the incoming Inpatient
 Part A claim (11x).

 Response
 The incoming Inpatient Part A claim (11x) is processed. An
 informational unsolicited response is generated for the
 RDF claim for A/B Crossover edit '729C'. The RDF claim is
 returned with Trailer '24' along with '43'. The Trailer '24'
 mask will be a 'K' to identify the RDF claim.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 143
______________________________________________________________________________


 Event 1.2
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008.

 An incoming Inpatient Part A claim (11x) is received with
 Action Code '4' (cancel). The posted RDF claim detail line
 item Date of Service is within the Admission and Discharge
 Date of the incoming Inpatient Part A claim (11x).

 Response
 The incoming Inpatient Part A claim (11x) is processed and
 no informational unsolicited response is generated for the
 RDF claim for A/B Crossover edit '729C'.

 Event 1.3
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008.

 An incoming Inpatient Part A claim (11x) is received with an
 'N' No-Pay Code. The posted RDF claim detail line item
 Date of Service is within the Admission and Discharge
 Date of the incoming Inpatient Part A claim (11x).

 Response
 The incoming Inpatient Part A claim (11x) is processed and
 no informational unsolicited response is generated for the
 RDF claim for A/B Crossover edit '729C'.

 Event 1.4
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008.

 An incoming Inpatient Part A claim (11x) is received. The
 posted RDF claim detail line item Date of Service is within
 the Admission and Discharge Date of the incoming Inpatient
 Part A claim (11x). The detail edit override table has '729C'
 present.

 Response
 The incoming Inpatient Part A claim (11x) is processed and
 no informational unsolicited response is generated for the
 RDF claim for A/B Crossover edit '729C'.



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 144
______________________________________________________________________________

 Event 1.5
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008.

 An incoming Inpatient Part A claim (11x) is received. The
 posted RDF claim detail line item Date of Service equals the
 Admission Date of the incoming Inpatient Part A claim (11x).

 Response
 The incoming Inpatient Part A claim (11x) is processed and
 no informational unsolicited response is generated for the
 RDF claim for A/B Crossover edit '729C'.

 Event 1.6
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008.

 An incoming Inpatient Part A claim (11x) is received. The
 posted RDF claim detail line item Date of Service equals the
 Discharge Date and the Patient Status is other than '30' on
 the incoming Inpatient Part A claim (11x).

 Response
 The incoming Inpatient Part A claim (11x) is processed and
 no informational unsolicited response is generated for the
 RDF claim for A/B Crossover edit '729C'.

 Event 1.7
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008 and the Action Code equals '4' (cancel).

 An incoming Inpatient Part A claim (11x) is received. The
 posted RDF claim detail line item Date of Service is within
 the Admission and Discharge Date of the incoming Inpatient
 Part A claim (11x).

 Response
 The incoming Inpatient Part A claim (11x) is processed and
 no informational unsolicited response is generated for the
 RDF claim for A/B Crossover edit '729C'.

 Event 1.8
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008 and the Action Code equals '7' (add to
 history).

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 145
______________________________________________________________________________

 An incoming Inpatient Part A claim (11x) is received. The
 posted RDF claim detail line item Date of Service is within
 the Admission and Discharge Date of the incoming Inpatient
 Part A claim (11x).

 Response
 The incoming Inpatient Part A claim (11x) is processed and
 no informational unsolicited response is generated for the
 RDF claim for A/B Crossover edit '729C'.

 Event 1.9
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008 and the No-Pay Code equals 'N'.

 An incoming Inpatient Part A claim (11x) is received. The
 posted RDF claim detail line item Date of Service is within
 the Admission and Discharge Date of the incoming Inpatient
 Part A claim (11x).

 Response
 The incoming Inpatient Part A claim (11x) is processed and
 no informational unsolicited response is generated for the
 RDF claim for A/B Crossover edit '729C'.

 Event 1.10
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008 and without a No-Pay Code 'N', but
 the Total Charge equals the Non-covered Charge for the detail
 line item.

 An incoming Inpatient Part A claim (11x) is received. The
 posted RDF claim detail line item Date of Service is within
 the Admission and Discharge Date of the incoming Inpatient
 Part A claim (11x).

 Response
 The incoming Inpatient Part A claim (11x) is processed and
 no informational unsolicited response is generated for the
 RDF claim for A/B Crossover edit '729C'.

 Event 2.1
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008.

 An incoming Inpatient Part B claim (12x) is received. The posted
 RDF claim detail line item Date of Service is within the From
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 146
______________________________________________________________________________

 and Thru Date of the incoming Inpatient Part B claim.

 Response
 The incoming Inpatient Part B claim (12x) is processed. An
 informational unsolicited response is generated for the
 RDF claim for A/B Crossover edit '729I'. The RDF claim is
 returned with Trailer '24' along with '43'. The Trailer
 '24' mask will be a 'K' to identify the RDF claim.

 Event 2.2
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008.

 An incoming Inpatient Part B claim (12x) is received with
 Action Code '4' (cancel). The posted RDF claim detail line
 item Date of Service is within the From and Thru Date of
 the incoming Inpatient Part B claim.

 Response
 The incoming Inpatient Part B claim is processed and no
 informational unsolicited response is generated for the
 RDF claim for A/B Crossover edit '729I'.

 Event 2.3
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008.

 An incoming Inpatient Part B claim (12x) is received with
 Action Code '7' (add to history). The posted RDF claim detail
 line item Date of Service is within the From and Thru Date
 of the incoming Inpatient Part B claim.

 Response
 The incoming Inpatient Part B claim is processed and no
 informational unsolicited response is generated for the
 RDF claim for A/B Crossover edit '729I'.

 Event 2.4
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008.

 An incoming Inpatient Part B claim (12x) is received with 'N'
 No-Pay code. The posted RDF claim detail line item Date of
 Service is within the From and Thru Date of the incoming
 Inpatient Part B claim.

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2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 147
______________________________________________________________________________

 Response
 The incoming Inpatient Part B claim is processed and no
 informational unsolicited response is generated for the RDF
 claim for A/B Crossover edit '729I'.

 Event 2.5
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008.

 An incoming Inpatient Part B claim (12x) is received. The
 posted RDF claim detail line item Date of Service is within
 the From and Thru Date of the incoming Inpatient Part B
 claim. The detail edit override table has '729I' present.

 Response
 The incoming Inpatient Part B claim is processed and no
 informational unsolicited response is generated for the RDF
 claim for A/B Crossover edit '729I'.

 Event 2.6
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008.

 An incoming Inpatient Part B claim (12x) is received. The
 posted RDF claim detail line item Date of Service equals
 the From Date of the Inpatient Part B claim.

 Response
 The incoming Inpatient Part B claim is processed and no
 informational unsolicited response is generated for the RDF
 claim for A/B Crossover edit '729I'.

 Event 2.7
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008.

 An incoming Inpatient Part B claim (12x) is received. The
 posted RDF claim detail line item Date of Service equals
 the Thru Date of the Inpatient Part B claim.

 Response
 The incoming Inpatient Part B claim is processed and no
 informational unsolicited response is generated for the RDF
 claim for A/B Crossover edit '729I'.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 148
______________________________________________________________________________

 Event 2.8
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008 and the Cancel Date is greater than
 zero.

 An incoming Inpatient Part B claim (12x) is received. The
 posted RDF claim detail line item Date of Service is within
 the From and Thru Date of the incoming Inpatient Part B claim.

 Response
 The incoming Inpatient Part B claim is processed and no
 informational unsolicited response is generated for the RDF
 claim for A/B Crossover edit '729I'.

 Event 2.9
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008 and Action Code '7' (add to history).

 An incoming Inpatient Part B claim (12x) is received. The
 posted RDF claim detail line item Date of Service is within
 the From and Thru Date of the incoming Inpatient Part B claim.

 Response
 The incoming Inpatient Part B claim is processed and no
 informational unsolicited response is generated for the RDF
 claim for A/B Crossover edit '729I'.

 Event 2.10
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008 and a No-Pay Code equal to 'N'.

 An incoming Inpatient Part B claim (12x) is received. The
 posted RDF claim detail line item Date of Service is within
 the From and Thru Date of the incoming Inpatient Part B claim.

 Response
 The incoming Inpatient Part B claim is processed and no
 informational unsolicited response is generated for the RDF
 claim for A/B Crossover edit '729I'.

 Event 2.11
 Posted to history is an RDF claim (72x) with Dates of Service
 on, or after 04/01/2008. A No-Pay Code 'N' is not present
 however, the Total Charge equals the Non-Covered Charge
 for that particular detail line item.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 149
______________________________________________________________________________

 An incoming Inpatient Part B claim (12x) is received. The
 posted RDF claim detail line item that is non-covered is
 within the From and Thru Date of the incoming Inpatient
 Part B claim.

 Response
 The incoming Inpatient Part B claim is processed and no
 informational unsolicited response is generated for the RDF
 claim for A/B Crossover edit '729I'.

 Event 3.1
 Posted to history is an Inpatient Part B claim (12x)
 with Dates of Service on or after 04/01/2007.

 An incoming RDF claim (72x) is received that has a
 detail line item Date of Service that within the From
 and Thru Date of the posted Inpatient Part B claim.

 Response
 The incoming RDF claim (72x) is rejected, and error
 code '729I' is set.

 Event 3.2
 Posted to history is an Inpatient Part B claim (12x)
 with Dates of Service on or after 04/01/2007.

 An incoming RDF claim (72x) is received that has a
 detail line item Date of Service that equals the
 From Date of the posted Inpatient Part B claim.

 Response
 The incoming RDF claim (72x) is processed, and error
 code '729I' is not set.

 Event 3.3
 Posted to history is an Inpatient Part B claim (12x)
 with Dates of Service on or after 04/01/2007.

 An incoming RDF claim (72x) is received that has a
 detail line item Date of Service that equals the
 Thru Date of the posted Inpatient Part B claim.

 Event 3.4
 Posted to history is an Inpatient Part B claim (12x)
 with Dates of Service on or after 04/01/2007.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 150
______________________________________________________________________________

An incoming RDF claim (72x) is received without a
No-Pay Code 'N', but the Total Charge equals the
Non-Covered Charge for the detail line item Date
of Service that is within the From and Thru Date
of the Inpatient Part B claim in history.

Response
The incoming RDF claim (72x) is processed, and error
code '729I' is not set.

The Entity List includes only NEW acronyms and terminology
that is currently not in use in CWF.

Entity List: N/A

Areas Affected by the Problem.
  1. Informational Unsolicited Module
  2. A/B Crossover Module

Solution Criteria: N/A

  EDITS AFFECTED:

a. Error Code:      729I   ( )New (X)Modified ( )Deleted
Disposition: CR

Type of Record: OUTP

Error Message:
For an ESRD claim (72x) the detail line item Date of Service is
within the From and Thru Date of the Inpatient Part B claim (12x).

Set Condition for edit '729I':
When incoming ESRD claim (72x) that has a detail line item
Date Service that is within the From and Thru Date of the
posted Inpatient Part B claim (12x), set the '729I'
error code.

The edit will apply to Dates of Service on, or after,
04/01/2007.

Bypass when:

   The incoming RDF claim has a detail line item date
   of service that equals the inpatient Part B claim
   From Date,
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 151
______________________________________________________________________________


  The incoming RDF claim has a detail line item date
  of service that equals the inpatient Part B claim
  Thru Date,

  The incoming RDF claim is submitted with Action code
  '4' (cancel only),

  The incoming RDF claim is submitted with Action code
  '7' (add to history),

  The incoming RDF claim is submitted with a 'N'
  No-Pay Code,

  The incoming RDF claim is submitted without a No-Pay
  Code 'N', but the Total Charge equals the Non-Covered
  Charge for detail line item that is within the From and
  Thru Date of the Inpatient Part B claim,

  The detail Edit Override Table has '729I' present,

  History Inpatient Part B claim (12x) Cancel Date is
  greater than zero,

  History Inpatient Part B claim (12x) Action Code
  equals '7' (add to history),

  History Inpatient Part B claim (12x) has a No-Pay Code
  equal to 'N'.

Trailer Information: 08, 13, 43

  INSTALLATION INSTRUCTIONS:   None

  SYSTEMS DOCUMENTATION AFFECTED:

    EDITALRT              ADD NEW IUR PROCESS FOR '729C'.
                          FOR AN RDF CLAIM (ESRD) (72X) THE DETAIL
                          LINE ITEM DATE OF SERVICE IS WITHIN THE
                          ADMISSION AND DISCHARGE DATE OF THE
                          INPATIENT CLAIM (11X)
                          SET CONDITION FOR IUR CODE '729C':
                          GENERATE INFORMATIONAL UNSOLICITED RESPONSE
                          ON A RDF CLAIM (ESRD) (72X) WHEN THE
                          DETAIL LINE ITEM DATE OF SERVICE IS WITHIN
                          THE ADMISSION AND DISCHARGE DATE OF THE
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 152
______________________________________________________________________________

                          INCOMING INPATIENT CLAIM (11X).
                          NOTE: SEE EDITABX FOR '729C' FOR DETAILED
                                SET CONDITIONS.
                          THE IUR WILL RETURN TRAILER '24' TO
                          IDENTIFY THE RDF CLAIM ON FULL HISTORY.
                          THE IUR CODE IN TRAILER '24' WILL BE '729C'
                          THE TRAILER '13' WILL IDENTIFY THE HOSPITAL
                          STAY CLAIM.
                          THE TRAILER '24' MASK WILL BE A K
                          ON THE IUR.
                          THE UNSOL IND ON THE RDF CLAIM IN HISTORY
                          WILL BE A K.
                          TRAILER INFORMATION: 13, 24, 43

    EDITALRT              ADD NEW IUR PROCESS FOR '729I'.
                          FOR AN RDF CLAIM (72X) (ESRD) THE DETAIL
                          LINE ITEM DATE OF SERVICE IS WITHIN THE
                          FROM AND THRU DATE OF AN INPATIENT PART B
                          CLAIM (12X).
                          SET CONDITION FOR IUR CODE 729I:
                          GENERATE INFORMATIONAL UNSOLICITED RESPONSE
                          ON A RDF CLAIM (72X) WHEN THE DETAIL LINE
                          ITEM DATE OF SERVICE ARE WITHIN THE FROM
                          AND THRU DATE OF THE INCOMING INPATIENT
                          PART B CLAIM (12X).
                          NOTE: SEE EDITABX FOR '729I' FOR DETAILED
                          SET CONDITIONS.
                          THE IUR WILL RETURN TRAILER '24' TO
                          IDENTIFY THE RDF CLAIM ON FULL HISTORY.
                          THE IUR CODE IN TRAILER '24' WILL BE
                          '729I'.
                          THE TRAILER '24' MASK WILL BE AN K
                          ON THE IUR.
                          THE UNSOL IND ON THE RDF CLAIM (72X) IN
                          HISTORY WILL BE AN K.
                          TRAILER INFORMATION 24, 43

    EDITLIST             ADD NEW ERROR MESSAGE FOR '729I'.

    EDITABX              ADD NEW ERROR MESSAGE FOR '729I'.

  SATELLITE SYSTEM MODIFICATIONS:   None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 153
______________________________________________________________________________

   13. 00025660   5790 CLINICAL TRIAL POLICY UPDATE

   REQUESTOR ID: CWFM2000

   IMPACT:
 (X) Host
 (X) Satellite Part A Inpatient
 (X) Satellite Part A Outpatient
 (X) Satellite Part B
 (X) Hospice
 (X) Home Health
 (X) DMERC

   REASON FOR CHANGE:
 CMS is in the process of revising its current national coverage
 determination (NCD) policy on clinical trials. The new policy
 will require sponsors/principal investigators to certify to CMS
 that the standards listed in section 310.1 of Pub.100-03, NCD
 Manual have been met to receive payment for patient care for
 Beneficiaries who are enrolled in clinical research studies.

 To meet this certification requirement, all providers and
 practitioners must begin including an 8-digit registry
 number on all their claims for Dates of Service on, or
 after 01/01/2008. Claims with a start date prior to
 to 01/01/2008 will be submitted with a default registry
 number 99999999.

 A new field header field is being created in CWF to
 allow the eight-byte 'Clinical Trial Number' to be
 submitted on incoming HUBC or HUDC records.

 Note:
 For Part A clinical trials (HUIP, HUOP, HUHH and HUHC),
 CMS has directed CWF to use existing fields to carry
 the clinical trial data. A 'D4' will be reported in the
 existing Value Code field, and the eight-byte 'Clinical
 Trial Number' will be reported in the existing Value
 Amount field.

   NEW BUSINESS REQUIREMENTS:

 Requirement 1
 CWF must create a new eight-byte field 'Clinical Trial
 Number' in the header of the incoming HUBC record.

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2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 154
______________________________________________________________________________

CABEHUBC   Copybook
   Field   Name     = HUBC-Clinical Trial Registry Number
   Field   Number   = 54
   Field   Position = 314-321

(The layout for the CABEHUBC copybook with the new field will be
 included with the external copybook CR 00025701).

Requirement 2
The layout for HUDC record is common to both HUBC and HUDC.
Therefore, the field numbers and names for HUDC will be the
same as the field numbers and names for the HUBC record.

CWF must create a new eight-byte field 'Clinical Trial
Number' in the header of the incoming HUDC record.

CABEHUBC Copybook
  Field Name      = HUBC-Clinical Trial Registry Number
  Field Number    = 54
  Field Position = 314-321

(The layout for the CABEHUBC copybook with the new field will be
 included with the external copybook CR 00025701).

Requirement 3
The valid values for the new eight-byte 'Clinical Trial Number'
field are numeric. If spaces or low values are sent in the new
field CWF will convert those values to zeroes.

If alpha values are submitted CWF will ------????

Requirement 4
CWF is not creating a new field for Part A records for clinical
trials. For claims received on, or after 01/01/2008 CWF must
process a 'D4' in the Value Code field and an eight-byte 'Clinical
Trial Number' in the Value Amount field as a clinical trial claim
for Part A records (HUIP, HUOP, HUHH and HUHC).

The Value Amount field is ten-bytes long. The 'Clinical Trial
Number' is eight-bytes long. When the Value Amount field is
being utilized for clinical trial, the eight-byte number should
be (preceded?? by, followed by two zeroes??)

 Requirement 5
 CWF must create and display a new eight-byte field in the
 header of the PTBH screen for Part B records in HIMR. The
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2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 155
______________________________________________________________________________

 new field will contain the 'Clinical Trial Number'.

 Note: The BLD DED has been moved over to place the CT NUM
       between the BLD DED and MSP FLAG.

 PTBH                            PART B CLAIM HISTORY                    PAGE     1
 HIC                                   LOCAL HOST                  DOB
 CORR                   NAME                                       DOD                S
 BOI 1 MSP 3 REP 2
                        INP 0000 OUT 0000 HOS 0000 PTB 0002 DME 0000 HHA 000
 NPI REF PHY                NPI CPO               REFER PHYS                    UPIN
 ICN                    NUM-LINES       ENTRY CD     CLM FROM            CLM THRU 1
 CARRIER                SURNAME APPLE FI M DOB                  SEX      ASSIGNMENT
                        EXCP/NONEXCP IND      SITE OF SERVICE
 CLAIM REIM                       BLD DED 00 CT NUM xxxxxxxx <<<<< MSP FLAG
 AMT PAID BY BENE                 PAY DENIAL IND                           MSP AMT
 DED MED                          PAY DENIAL DTE                           ACCIDENT
 CASH DED                         CLAIM RECEIPT DTE                        PAT REL
 CO INS                           CPT INTEREST               UNSOL IND     LIAB IND
 DED PSYC                         COMP CARRIER               SANC PROV     WORK RELA
 DED PTHPY                        COMP ID NUM                              SIGNATURE
 DED OTHPY                        COMP IND               DOA               CANC
 DG1        DG2         DG3         DG4         DG5        DG6         DG7         DG
 CLEAN CLM      SPLIT       ADJ: MASS     CLM       BENE DIED       PRIVACY     MICR
 REP PAYEE      SRCE      AUTO ADJ       IND3            IND4       IND5        HCPC
 REMARKS:                   SUBMITTER 12599               DEMO NUM              EXAM
 OVERRIDE EDIT1:          EDIT2:         EDIT3:        EDIT4:        EDIT5:



      F2=MENU F3=RETURN F4=BENA F5=BENB F7=BWD F8=FWD F12=EXIT

 Requirement 6
 CWF must create and display a new eight-byte field in the
 header of the DMEH screen for DMERC records in HIMR. The
 new field will contain the 'Clinical Trial Number'.

 DMEH                         DMEPOS CLAIM HISTORY               PAGE    1
 HIC                                LOCAL HOST             DOB
 CORR                 NAME                                 DOD
 CMN 1 HOS 1 MSP 1 REP 2 SUR 1
                  INP 0001 OUT 0001 HOS 0001 PTB 0001 DME 0001 HHA 000
 NPI HEADER
 ICN DISP             NUM-LINES    ENTRY CD    CLM FROM          CLM THRU
 DMERC                SURNAME APPLE FI M DOB            SEX M    ASSIGNMENT
 IDE NUMBER:                                 ADJ: MASS   CLM
______________________________________________________________________________
2020 Company, LLC                                            Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 156
______________________________________________________________________________

CLAIM REIM                                                        MSP FLAG
AMT PAID BY BENE              PAY DENIAL IND                      MSP AMT
DED MED                       PAY DENIAL DTE                      ACCIDENT
CASH DED                      CLAIM RECEIPT DTE                   PAT REL
CO INS                        CPT INTEREST                        SANC-IND
UNSOL IND    IHS IND          COMP CARRIER                        WORK RELA
CT NUM xxxxxxxx <<<<<<<       COMP ID NUM                         SIGNATURE
LIAB IND      NCPDP IND       COMP IND            DOA             CANC
                     REFER UPIN         DIAG CD: PRI        SEC1       SEC2
CLEAN CLM    SPLIT                           BENE DIED      PRIVACY    MICR
REP PAYEE    SRCE      AUTO ADJ    IND3           IND4      IND5       HCPC
REMARKS:                SUBMITTER                  DEMO NUM            EXAM
OVERRIDE EDIT1:        EDIT2:      EDIT3:       EDIT4:       EDIT5:

        F2=MENU F3=RETURN F4=BENA F5=BENB F7=BWD F8=FWD F12=EXIT

Requirement 7
CWF must create and display a new eight-byte field in the
header of the HIBC record in the Internal Testing Facility
(ITF). The new field will contain the 'Clinical Trial Number'.

         CABLE PART B CLAIM                             TRANSID   HIBC    PAGE

HI-CLAIM-NUM                 SURNAME APPLE     FIRST-INIT     SEX
CARRIER                  REQ-ID        RESPONSE-CODE C PRINTER-DESTINATION
NUM-LINES      ENTRY-CODE 1 INVESTIGATION-IND        SPLT-CLM-IND      PAY-DEN
HCPCS-YR       ADJ: MASS     CLM                      DOC-CTL-NO
REFER-PHYS                         CLM-RCPT-DT             PAY-DEN-DT
REP-PAYEE-IND      SUBMITTER-ID               ACCIDENT-SW     PAT-REL-IND
WORK-REL-IND     SIGNATURE-IND      BENE-DIED-IND      COMP-IND
COMP-CARRIER            COMP-ID-NUM                          ASSIGN-IND
AMT-PAID-BY-BENE 000000 PRIVACY-FLAG         DT-BILLED           EXAMINER-NUM
REMARKS                 MICRO-IND     UPIN         EXCP/NONEXCP-IND
DIAG1        DIAG2        DIAG3        DIAG4        DEMO-NUMBER
DIAG5        DIAG6        DIAG7        DIAG8        CT-NUM xxxxxxxx <<<<<<<
CROSSOVER ID:                          LIAB IND     SANCTIONED PROV:
IDE-NUMBER            CPO-NUMBER           SITE OF SERVICE
NPI-REFER-PHYS              NPI-CPO
OVERRIDE EDIT1:         EDIT2:       EDIT3:       EDIT4:        EDIT5:




  2-ISA+SAVE   4-NO DATA   12-ENTER TXN   7-UP   8-DN    10-ISA 13-SAVE   14-RE


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 157
______________________________________________________________________________

 Requirement 8
 CWF must create and display a new eight-byte field in the
 header of the HIDC record in the Internal Testing Facility
 (ITF). The new field will contain the 'Clinical Trial Number'.

      DMEPOS CLAIM                                 TRANSID    HIDC   PAGE

 HI-CLAIM-NUM                  SURNAME        FIRST-INIT     SEX
 DMERC                  DOB            REQ-ID      RESPONSE-CODE     PRINTER
 NUM-LINES      ENTRY-CODE      INVESTIGATION-IND     SPLT-CLM-IND     PAY-DEN
 HCPCS-YR       ADJ: MASS      CLM                     DOC-CTL-NO
 CLM-RCPT-DT           PAY-DEN-DT
 REP-PAYEE-IND      SUBMITTER-ID               ACCIDENT-SW     PAT-REL-IND
 WORK-REL-IND     SIGNATURE-IND      BENE-DIED-IND      COMP-IND
 COMP-CARRIER            COMP-ID-NUM                          ASSIGN-IND
 AMT-PAID-BY-BENE            PRIVACY-FLAG     DT-BILLED          EXAMINER-NUM
 REMARKS                 MICRO-IND     UPIN A77581 NPI-HEADER
 DIAG2        DIAG3         DIAG4       DIAG5        DEMO-NUMBER
 CROSSOVER ID:                                       LIAB IND       IHS-IND
 IDE-NUMBER              CT NUM XXXXXXXX <<<<<<<     NCPDP IND      SANC-IND
 OVERRIDE EDIT1:         EDIT2:       EDIT3:       EDIT4:       EDIT5:


 2-ISA+SAVE    4-NO DATA   12-ENTER TXN   7-UP   8-DN   10-ISA 13-SAVE   14-REWR

 Requirement 9
 CWF must create and display on the NCH (National Claim History)
 file a new eight-byte field in the header of the HUBC/HUDC
 record that will contain the 'Clinical Trial Number' for claims
 received on, or after 01/01/2008.

 CABEHIBC   Copybook
    Field   Name     = HUBC-Clinical Trial Registry Number
    Field   Number   = 82e
    Field   Position = 503-510

 (The layout for the CABEHIBC copybook with the new field will be
  included with the external copybook CR 00025701).

 Requirement 10
 CWF must ensure when clinical trial data for Part A is
 indicated in the Value Code and Value Amount field the
 data is displayed on the INPH, OUTH, HOSH and HHAH
 screens in HIMR.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 158
______________________________________________________________________________

 Requirement 11
 CWF must ensure when clinical trial data for Part A is
 indicated in the Value Code and Value Amount field for
 HIIP, HIOP, HIHH and HIHC records the data is displayed
 in the Internal Testing Facility (ITF).

 Requirement 12
 CWF must ensure when clinical trial data for Part A is
 indicated in the Value Code and Value Amount field for
 HUIP, HUOP, HUHH and HUHC records the values are carried
 to the NCH (National Claim History) file.

 Requirement 13
 CWF must create and display in the CIOCPTB copybook (internal
 to CWF) a new eight-byte field in the header of the HUBC/HUDC
 record that will contain the 'Clinical Trial Number' for
 claims received on, or after 01/01/2008.

 Requirement 14
 CWF will create a new monthly report (Clinical Trial Data)
 that will be sent to CMS.

 Data on the report will be for claims submitted on, or after
 01/01/2008.

 The report will contain the following data:

  1 Individual Clinical Trial Numbers

   -A list of ICNs for each of the individual Clinical Trial
    Numbers

     -A list of the Modifiers for each claim (ICN) for the
      individual Clinical Trial Number
            a)Modifiers 'QO' and 'Q1'
            b)Modifier 'Q1'
            c)Modifier 'QO'
            d)neither Modifier 'QO' or 'Q1'

    A total of all the claims for each 'Clinical Trial
    Number'.

    A total number of patients for each 'Clinical Trial
    Number'.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 159
______________________________________________________________________________

 CWF needs:
              Instruction on how to handle merged Benes (active
              Bene has CT claims, inactive Bene doesn't, and vice
              versus).

   EVENT-RESPONSE LIST:

 Event 1.1
 An HUBC record that contains a new eight-byte 'CLINICAL TRIAL
 NUMBER' is submitted.

 Response
 The incoming record is processed in CWF.

 Event 2.1
 An HUDC record that contains a new eight-byte 'CLINICAL TRIAL
 NUMBER' is submitted.

 Response
 The incoming record is processed in CWF.

 Event 3.1
 An HUBC record is submitted that contains spaces or low values
 in the new eight-byte 'CLINICAL TRIAL NUMBER' field.

 Response
 CWF converts the values to zeroes, and the claim is processed in
 CWF.

 Event 3.2
 An HUBC record is submitted that contains alpha characters in the
 new eight-byte 'CLINICAL TRIAL NUMBER' field.

 Response
 Under development

 Event 3.3
 An HUDC record is submitted that contains spaces or low values
 in the new eight-byte 'CLINICAL TRIAL NUMBER' field.

 Response
 CWF converts the values to zeroes, and the claim is processed in
 CWF.

 Event 3.4
 An HUDC record is submitted that contains alpha characters in the
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 160
______________________________________________________________________________

 new eight-byte 'CLINICAL TRIAL NUMBER' field.

 Response
 Under development

 Event 4.1
 An HUIP, HUOP, HUHH, or HUHC record that contains a 'D4'
 in the Value Code field, and a eight-byte 'CLINICAL TRIAL
 NUMBER' in the Value Amount field is submitted. The
 'CLINICAL TRIAL NUMBER' is preceded, followed by two
 zeroes.

 Response
 The incoming record is processed in CWF.

 Event 4.2
 An HUIP, HUOP, HUHH, or HUHC record that contains a 'D4'
 in the Value Code field, and the Value Amount field contains
 spaces or low values.

 Response
 CWF converts the values to zeroes, and the claim is processed in
 CWF. The claim is not processed as a clinical trial.

 Event 4.3
 An HUIP, HUOP, HUHH, or HUHC record is submitted that contains
 a 'D4' in the Value Code field, and the Value Amount field
 contains zeroes.

 Response
 The incoming record is processed in CWF, but not as a clinical
 trial.

 Event 4.4
 An HUIP, HUOP, HUHH, or HUHC record is submitted that contains
 a 'D4' in the Value Code field, and the Value Amount field
 contains alpha characters.

 Response
 The claim is rejected, consistency error code '46#1' is set.

 Event 4.5
 An HUIP, HUOP, HUHH, or HUHC record is submitted that does not
 contain a 'D4' in the Value Code field, but does contain an
 eight-byte 'CLINICAL TRIAL NUMBER' in the Value Amount field.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 161
______________________________________________________________________________

 Response
 The incoming record is processed in CWF, but not as a clinical
 trial.

 Event 5.1
 Access a HUBC record in HIMR.

 Response
 The record will contain a new eight-byte field 'CLINICAL
 TRIAL NUMBER' in the header of the record.

 Event 6.1
 Access a HUDC record in HIMR.

 Response
 The record will contain a new eight-byte field 'CLINICAL
 TRIAL NUMBER' in the header of the record.

 Event 7.1
 Access a HIBC record in ITF.

 Response
 The record will contain a new eight-byte field 'CLINICAL
 TRIAL NUMBER' in the header of the record.

 Event 8.1
 Access a HIDC record in ITF.

 Response
 The record will contain a new eight-byte field 'CLINICAL
 TRIAL NUMBER' in the header of the record.

 Event 9.1
 Review the NCH file for an HUBC or HUDC record.

 Response
 The file contains a new eight-byte field 'CLINICAL TRIAL
 NUMBER'.

 Event 10.1
 Access an HUIP, HUOP, HUHH or HUHC record in HIMR for a
 claim that processed with clinical trial data.

 Response
 The Value Code field contains a 'D4', and the Value Amount
 field contains a 'CLINICAL TRIAL NUMBER'.
______________________________________________________________________________
2020 Company, LLC                                           Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 162
______________________________________________________________________________


 Event 11.1
 Access an HIIP, HIOP, HIHH or HIHC record in ITF for a
 claim that processed with clinical trial data.

 Response
 The Value Code field contains a 'D4', and the Value Amount
 field contains a 'CLINICAL TRIAL NUMBER'.

 Event 12.1
 Review the NCH file for a Beneficiary who has an HUIP, HUOP,
 HUHH or HUHC record that contains clinical trial data.

 Response
 The Value Code field contains a 'D4', and the Value Amount
 field contains a 'CLINICAL TRIAL NUMBER'.

 Event 13.1
 Review copybook CIOCPTB for an HUBC or an HUDC record.

 Response
 A new eight-byte field has been added in the header of
 the record.

 Event 14.1
 Review the monthly Clinical Trial Data report generated for CMS.

 Response
 The report contains individual clinical trial numbers, the
 Modifiers on the each claim for each clinical trial number
 the total number of claims submitted and the number of
 patients (Beneficiaries) who had claims submitted.

 The Entity List includes only NEW acronyms and terminology
 that is currently not in use in CWF.

 Entity List: N/A
   1. Entity: Clinical Trial Report
       Description: New report created by CMS to provide
                     CMS specific data regarding what
                     clinical trial numbers are being billed
                     and the specifics of the claims linked
                     to those clinical trial numbers.
   2. Entity: New field - Clinical Trial Number
       Description: Eight-byte field that will contain
                     numeric Clinical Trial Registry number.
______________________________________________________________________________
2020 Company, LLC                                           Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 163
______________________________________________________________________________


Areas   Affected by the Problem.
  1.    Part A, OUTP, HHA and Hospice
  2.    Part B Carrier
  3.    DMERC

Solution Criteria: N/A

  EDITS AFFECTED:     None

  INSTALLATION INSTRUCTIONS:      None

  SYSTEMS DOCUMENTATION AFFECTED:

    COPYXTNL                 ADD NEW FIELD TO CABEHUBC FOR HUBC AND
                             HUDC.

    DATA DICTIONARY          ADD DEFINITION OF NEW FIELD 'CLINICAL TRIAL
                             NUMBER' FOR HUBC AND HUDC TO CABEHUBC.

    DATA DICTIONARY          ADD DEFINITION OF NEW FIELD 'CLINICAL TRIAL
                             NUMBER' FOR HUBC AND HUDC TO CABEHIBC.

    DATA DICTIONARY          ADD DEFINITION OF NEW FIELD 'CLINICAL TRIAL
                             NUMBER' FOR HUBC AND HUDC TO CIOCPTB.

    SCRHOST                  ADD NEW FIELD 'CLINICAL TRIAL NUMBER' TO
                             ITF FOR HUBC AND HUDC.

    OVERINFO                 ADD NEW FIELD 'CLINICAL TRIAL NUMBER' FOR
                             HUBC AND HUDC.

    OVERHIMR                 ADD NEW HEADER FIELD 'CLINICAL TRIAL
                             NUMBER' FOR HUBC AND HUDC.

    HIMRNAV                  ADD NEW HEADER FIELD 'CLINICAL TRIAL
                             NUMBER' FOR HUBC AND HUDC.

  SATELLITE SYSTEM MODIFICATIONS:        None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 164
______________________________________________________________________________

  14. 00025665     51#3 SETTING INCORRECTLY ON TOB 11X WHEN DETAIL NONCOVERED

  REQUESTOR ID: CWFM2000

  IMPACT:
( ) Host
(X) Satellite Part A Inpatient
(X) Satellite Part A Outpatient
( ) Satellite Part B
( ) Hospice
( ) Home Health
( ) DMERC

  REASON FOR CHANGE:
CWF is not bypassing consistency edit '51#3' for Type of Bill
'11X', when detail setting the edit is non-covered.
The system documentation is not addressing set conditions for
Type of Bill '11X' and also needs to add the bypass condition
when the detail line setting the edit is non-covered.
Edit description is not as per code. This edit also checks for
Type of Bill '11X' and then sets edit based on REV code and
other conditions. Claims are setting edit due to TOB '11X' and
other bypass conditions are not met for REV-LINE + 25.

  NEW BUSINESS REQUIREMENTS:

Requirement 1
CWF must modify consistency edit '51#3' to bypass Type of Bill
'11X' when the detail setting the edit is non-covered.

  EVENT-RESPONSE LIST:

Event 1.1
Submit an HUIP record using Type of Bill '11X' and one
detail requiring units is missing and the charges are non-covered,
however, the other charges on the claim are covered.

Response
The record is accepted, error code '51#3' is not set.

The Entity List includes only NEW acronyms and terminology
that is currently not in use in CWF.

Entity List: N/A

 Areas Affected by the Problem.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 165
______________________________________________________________________________

   1. Consistency Module (HUIPCED)

 Solution Criteria: N/A

   EDITS AFFECTED:

 a. Error Code:      51#3     ( )New (X)Modified ( )Deleted
 Disposition: ER

 Type of Record: HHA, Hospice, Hospital, OUTP, SNF

 Error Message:
 Revenue Code Unit missing or invalid.

 NOTE:     Units field on Revenue Code line must be
           greater than zero for the following Type of Bill
           and Revenue Code combinations:

    Edit performed for Bill Type and Revenue Codes:
    11x               0100-0169, 0200-0219, 0381, 0382,
                      0801-0804

    13x                     0300-0319, 0510-0519, 0381, 0382,
                            0403, 0450, 0459, 0821

    18x, 21x                0100-0169, 0381, 0382, RUGS Revenue
                            Codes 9000-9044, for TOB '21x' too,
                            if the Override Code '4' is present,
                            and SNF PPS (TOB 21x) Revenue Code
                            '0022'.

    14x, 22x,
    73x, 85x                403, or 096x, 097x, 098x with 85x
    or 71x                  (Provider Range 3400-3499, 3975-3999
                            or 8500-8899)

     23x                    0300-0319, 0381, 0382
     28x                    RUGS Revenue Codes
     32x                    010x-024x, 044x-053x, 028x, 030x, 041x,
                            060x, 087x

     33x, 34x               042x-044x, 055x-057x, 0472

     41x, 51x               0100-0169, 0200-0219

     71x              0300-0319, 042x-044x, 051x, 055x-057x,
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 166
______________________________________________________________________________

                      0381, 0382, 0472

    72x               0300-0319, 0381, 0382, 0821, 0831, 0841,
                      0851, 0881

    73x               0510, 0520, 0910
    74x               0410-0449, 0550-0569, 0472

    81x, 82x          0650-0659

    83x               0300-0319, 0510-0519, 0381, 0382, 0450,
                      0459, 0821

 Set Condition for edit '51#3':

 When the revenue units are missing and the first two
 positions of the bill type are equal to '11', and the
 Revenue Code is '0100-'0169', '0200-0219', '0381', '0382'
 or '0801-0804', set the '51#3' error code.

 When the revenue units are missing and the first two
 positions of the bill type are equal to '13', and the
 Revenue Code is '0300-0319', '0381', '0382', '403',
 '0450', '0459', '0510-0519', or '0821', set the '51#3'
 error code.

 When the revenue units are missing and the first two
 positions of the bill type are equal to '18' or '21' and
 the Revenue Code is '0100-0169', '0381', or '0382',
 Rugs Revenue Codes '9000-9044', and override code equals
 '4' and (SNF PPS TOB 21x) or Revenue Code '0022', set the
 '51#3' error code.

 When the revenue units are missing and the first two
 positions of the bill type are equal to '14', '22', '71',
 '73' or '85' and the Revenue Code is '0403', '0960-0969',
 '0970-0979', or '0980-0989', with Bill type '85' or
 (Provider Range) '3400-3499', '3975-3999', '8500-8899',
 set the '51#3' error code.

 When the revenue units are missing and the first two
 positions of the bill type are equal to '23'and the
 Revenue Code is '0300-0319', '0381', or '0382',
 set the '51#3' error code.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 167
______________________________________________________________________________

 When the revenue units are missing and the first two
 positions of the bill type are equal to '28 and the
 Revenue Code is Rugs Revenue Codes, set the '51#3'
 '51#3' error code.

 When the revenue units are missing and the first two
 positions of the bill type are equal to '32' and the
 Revenue Code is '0100-0249', '0280-0289', '0300-0309',
 '0410-0419', '0440-0539', '0600-0609', or '0870-0879',
 set the '51#3' error code.

 When the revenue units are missing and the first two
 positions of the bill type are equal to '33' or '34' and
 Revenue Code is '0420-0449', '0472, '0550' or '0579',
 set the '51#3' error code.

 When the revenue units are missing and the first two
 positions of the bill type are equal to '41' or '51'
 and Revenue Code is '0100-0169', '0200-0219', set the
 '51#3' error code.

 When the revenue units are missing and the first two
 positions of the bill type are equal to '71', and the
 Revenue Code is '0300-0319', '0420-0449', '0510-0519',
 '0550-0579', '0381', '0382', or '0472', set the '51#3'
 error code.

 When the revenue units are missing and the first two
 positions of the bill type are equal to '72', and the
 Revenue Code is '0300-'0319', '0381', '0382', '0821',
 '0831', '0841', '0851', or '0881', set the '51#3'
 error code.

 When the revenue units are missing and the first two
 positions of the bill type are equal to '73', and the
 Revenue Code are equal to '0410-0499', '00472', '0510',
 '0520', '0550-0569', set the '51#3' error code.

 When the revenue units are missing and the first two
 positions of the bill type are equal to '74', and the
 Revenue Code is '0410-0449', '0472', '0550-0569', set the
 '51#3' error code.

 When the revenue units are missing and the first two
 positions of the bill type are equal to '81' or '82' and
 the Revenue Code is '0650-0659', set the '51#3' error code.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 168
______________________________________________________________________________


 When the revenue units are missing and the first two
 positions of the bill type are equal to '83' and the
 Revenue Code is '0300-0319', '0381', '0382', '0450',
 '0459', '0510-0519',or '0821', set the '51#3' error code.

 When the revenue units are missing on MAMMOGRAPHY BILL for
 Revenue Code '0403', '0960-0969', '0970-979', '0980-'0989'
 with Type of Bill '85x', set the '51#3' error code.

 When the revenue units are missing on MAMMOGRAPHY BILL
 ('76092', 'G0202', '76083') for Revenue Code '0403' with
 Type of Bill '12x' and Date of Service on or after
 07/01/2006, set the '51#3' error code.

 When the revenue units are missing on MAMMOGRAPHY BILL
 ('77052', '77057') for Revenue Code '0403' with Type of
 Bill '12x' and Date of Service on or after 01/01/2007,
 set the '51#3' error code.

 When the Action Code is '4', bypass this edit.

 When the financial units are zeros, and the financial or
 Revenue Override Code is equal to '4', bypass this edit.

 When the Primary Payer Amount is greater than zero,
 bypass this edit.

 When the No-Pay Code is 'N', bypass this edit.

 When the Total Charges for the detail setting the edit
 equal the Non-covered Charges, bypass this edit.

 Trailer Information:   08

   INSTALLATION INSTRUCTIONS:     None

   SYSTEMS DOCUMENTATION AFFECTED:

     EDITCONS                MODIFY CONSISTENCY EDIT '51#3' TO BYPASS
                             WHEN DETAIL IS NONCOVERED.

   SATELLITE SYSTEM MODIFICATIONS:       None



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 169
______________________________________________________________________________

   15. 00025668   5805-NEW MODIFIERS WHEN BILLING IN CLINICAL RESEARCH STUDIES

   REQUESTOR ID: CWFM2000

   IMPACT:
 (X) Host
 ( ) Satellite Part A Inpatient
 ( ) Satellite Part A Outpatient
 (X) Satellite Part B
 ( ) Hospice
 ( ) Home Health
 (X) DMERC

   REASON FOR CHANGE:
 The 2007 Annual HCPCS update contains the following three
 Modifiers that are to be billed for patient care when a
 Beneficiary is enrolled in a clinical research study.

  'QA' - FDA Investigational Device Exemption (Not used in CWF)
  'QR' - Item or Service Provided in a Medicare Specified Study
  'QV' - Item or Service Provided as Routine Care in a Medicare
         Qualifying Clinical Trial

 It has come to CMS' attention that these Modifiers are not
 being used as intended. As a result, CMS is revising its
 Modifier coding policy.

 CMS is discontinuing the 'QA', 'QR' and 'QV' Modifiers as of
 12/31/2007. Two new Modifiers are being created that will be
 used solely to differentiate between routine and investigational
 clinical services. These two new Modifiers will be included
 with the 2008 Annual HCPCS update and are effective for Dates
 of Service on, or after 01/01/2008.

 'Q0' - Investigational clinical service provided in a clinical
        research study that is in an approved clinical research
        study.

 'Q1' - Routine clinical service provided in a clinical research
        study that is in an approved clinical research study.

 The 'Q0' replaces the 'QA' and the 'QR'.
 The 'Q1' replaces the 'QV'.



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 170
______________________________________________________________________________

     NEW BUSINESS REQUIREMENTS:

Requirement 1
CWF must modify utilization error code '5232' to bypass
when a Beneficiary that has risk HMO has an incoming
HUDC record with Dates of Service on, or after 01/01/2008
and the Dates of Service are during the HMO period. All
the details on the claim contain the 'Q0' Modifier. The
Deductible Indicator on all the details is equal to '1'.

Requirement 2
CWF must modify utilization error code '5232' to bypass
when a Beneficiary that has risk HMO has an incoming
HUDC record with Dates of Service on, or after 01/01/2008
and the Dates of Service are during the HMO period. All
the details on the claim contain the 'Q1' Modifier. The
Deductible Indicator on all the details is equal to '1'.

Requirement 3
CWF must modify utilization error code '5270' to set when a
Beneficiary that has risk HMO has an incoming HUDC record
with Dates of Service on, or after 01/01/2008 and the Dates
of Service are during the HMO period. All the details on
the claim contain the 'Q0' Modifier. The Deductible
Indicator on all the details is not equal to '1'.

OR

CWF must modify utilization error code '5270' to set when
HUDC records contain a Date of Service on, or after 01/01/2008,
and the 'Q0' Modifier is not present on all details when the
Dates of Service are during the risk HMO period.

Requirement 4
CWF must modify utilization error code '5270' to set when a
Beneficiary that has risk HMO has an incoming HUDC record
with Dates of Service on, or after 01/01/2008 and the Dates
of Service are during the HMO period. All the details on
the claim contain the 'Q1' Modifier. The Deductible
Indicator on all the details is not equal to '1'.

OR

 CWF must modify utilization error code '5270' to set when
 HUDC records contain a Date of Service on, or after 01/01/2008,
 and the 'Q1' Modifier is not present on all details when the
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 171
______________________________________________________________________________

 Dates of Service are during the risk HMO period.

 Requirement 5
 CWF must modify utilization error code '5232' to bypass
 when a Beneficiary that has risk HMO has an incoming
 HUBC record with Dates of Service on, or after
 01/01/2008 and the Dates of Service are during the
 HMO period. All the details on the claim contain the
 the 'Q1' Modifier. The Deductible Indicator on all the
 details is equal to '1'.

 Requirement 6
 CWF must modify utilization error code '5270' to set
 when a Beneficiary that has risk HMO has an incoming
 HUBC record with Dates of Service on, or after
 01/01/2008 and the Dates of Service are during the
 HMO period. All the details on the claim contain the
 'Q1' Modifier. The Deductible Indicator on the all the
 details is not equal to '1'.

 OR

 CWF must modify utilization error code '5270' to set when
 HUBC records contain a Date of Service on, or after 01/01/2008,
 and the 'Q1' Modifier is not present on all details when the
 Dates of Service are during the risk HMO period.

 Requirement 7
 CWF must modify the Informational Unsolicited Response
 process for HHMO overlays (5232) to not generate when
 an HUDC record is submitted for a Beneficiary that has
 a risk HMO and the Dates of Service on the incoming
 claim are on, or after 01/01/2008 and the Dates of Service
 on the claim are during the HMO period. All the details
 on the claim contain the 'Q0' or the 'Q1' Modifier. The
 Deductible Indicator on all the details is equal to '1'.

 Requirement 8
 CWF must modify the Informational Unsolicited Response
 process for HHMO overlays (5232) to not generate when
 an HUBC record is submitted for a Beneficiary that has
 a risk HMO and the Dates of Service on the incoming
 claim are on, or after 01/01/2008 and the Dates of Service
 on the claim are during the HMO period. All the details
 on the claim contain the 'Q1' Modifier. The Deductible
 Indicator on all the details is equal to '1'.
______________________________________________________________________________
2020 Company, LLC                                           Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 172
______________________________________________________________________________


 Note: Claims sent to CWF with Dates of Service prior to 01/01/2008
       will use the existing logic for Modifiers 'QR' and 'QV'.

       Modifiers 'QR' and 'QV' are invalid for Dates of Service
       12/31/2007 and will be returned to the Provider as
       Unprocessable when submitted on, or after 01/01/2008.

   EVENT-RESPONSE LIST:

 Event 1.1
 Submit an HUDC record that contains a Date of Service on,
 or after 01/01/2008 that contains a 'Q0' Modifier. The
 Dates of Service are within the Beneficiary's HMO period.
 All the line item details on the claim contain a Deductible
 Indicator equal to '1'.

 Response
 The record is processed, error code '5232' is not set.

 Event 2.1
 Submit an HUDC record that contains a Date of Service on,
 or after 01/01/2008 that contains a 'Q1' Modifier. The
 Dates of Service are within the Beneficiary's HMO period.
 All the line item details on the claim contain a Deductible
 Indicator equal to '1'.

 Response
 The record is processed, error code '5232' is not set.

 Event 3.1
 Submit an HUDC record that contains Dates of Service on,
 or after 01/01/2008. All the detail lines on the claim
 do not contain a 'Q0' Modifier. The Dates of Service are
 within the Beneficiary's HMO period.

 Response
 The record is rejected, error code '5270' is set.

 Event 3.2
 Submit an HUDC record that contains a Date of Service on,
 or after 01/01/2008. All the detail lines on the claim
 contain the 'Q0' Modifier. The Dates of Service are
 within the Beneficiary's HMO period. The Deductible
 Indicator is not '1' on all details.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 173
______________________________________________________________________________

 Response
 The record is rejected, error code '5270' is set.

 Event 4.1
 Submit an HUDC record that contains Dates of Service on,
 or after 01/01/2008. All the detail lines on the claim
 do not contain a 'Q1' Modifier. The Dates of Service are
 within the Beneficiary's HMO period.

 Response
 The record is rejected, error code '5270' is set.

 Event 4.2
 Submit an HUDC record that contains a Date of Service on,
 or after 01/01/2008. All the detail lines on the claim
 contain the 'Q1' Modifier. The Dates of Service are
 within the Beneficiary's HMO period. The Deductible
 Indicator is not '1' on all details.

 Response
 The record is rejected, error code '5270' is set.

 Event 5.1
 Submit an HUBC record that contains a Date of Service on,
 or after 01/01/2008 that contains a 'Q1' Modifier. The
 Dates of Service are within the Beneficiary's HMO period.
 All the line item details on the claim contain a Deductible
 Indicator equal to '1'.

 Response
 The record is processed, error code '5232' is not set.

 Event 6.1
 Submit an HUBC record that contains Dates of Service on,
 or after 01/01/2008. All the detail lines on the claim
 do not contain a 'Q1' Modifier. The Dates of Service are
 within the Beneficiary's HMO period.

 Response
 The record is rejected, error code '5270' is set.

 Event 6.2
 Submit an HUBC record that contains a Date of Service on,
 or after 01/01/2008. All the detail lines on the claim
 contain the 'Q1' Modifier. The Dates of Service are
 within the Beneficiary's HMO period. The Deductible
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 174
______________________________________________________________________________

 Indicator is not '1' on all details.

 Response
 The record is rejected, error code '5270' is set.

 Event 7.1
 An HHMO transaction is received for a Beneficiary that
 has an HUDC record posted to history with Dates of
 Service on, or after 01/01/2008. The record contains a
 'Q0' or 'Q1' on all the detail line items. All the
 detail line items also contain a '1' in the Deductible
 Indicator field. The Dates of Service on the posted
 claim are within the Beneficiary's HMO period.

 Response
 An Informational Unsolicited Response is not generated.

 Event 8.1
 An HHMO transaction is received for a Beneficiary that
 has an HUBC record posted to history with Dates of
 Service on, or after 01/01/2008. The record contains a
 'Q1' on all the detail line items. All the detail line
 items also contain a '1' in the Deductible Indicator
 field. The Dates of Service on the posted claim are
 within the Beneficiary's HMO period.

 Response
 An Informational Unsolicited Response is not generated.

      EDITS AFFECTED:

 a. Error Code:         5232   ( )New (X)Modified ( )Deleted
 Disposition:           UR

 Type of Record:        Pt. B Carrier

 Error Message:
 Services overlap GHO Entitlement and
 Override Code is not '1' (investigation
 shows GHO not applicable).

 OR

 Services overlap Choices/ESRD Managed
 Care Demonstration entitlement and the
 Choices/ESRD ID Number is not present.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 175
______________________________________________________________________________


Set Condition for edit '5232':

When the claim Dates of Service overlap an ESRD or CHOICES
GHO period, and the claim GHO number is not a valid
CHOICES or ESRD ID, set the '5232' error code.

When the Plan ID is for Choices or ESRD, and override code
is present, set the '5232' error code.

When the claim Dates of Service overlap a non-ESRD or
CHOICES GHO period, and the claim GHO number does not
match the GHO number on the Beneficiary master record, or
does not exist, and the header Override Code table does
not indicate '5232', set the '5232' error code.

When a claim for a Beneficiary that is in a Risk
Management Plan has a Date of Service on or after
01/01/2006, contains a Modifier equal to 'KZ', and a
procedure code of '33249', set the '5232' error code.

When 'QV' Modifier is not present in all detail lines, set
the '5232' error code.

If the claim does not contains a 'Q1' Modifier in all
details and Date of Service is on or after 01/01/2008,
and risk HMO and Dates of Service are during the HMO period
or the Deductible Indicator does not equal 1 on all detail
lines; Set this edit.

If the claim Dates of Service are within a GHO period, and
the claim Dates of Service are also within a Hospice
period, and the header Override Code table does indicate
'5232', bypass this edit.

If the Beneficiary is enrolled in both GHO and Hospice,
bypass this edit.

If the claim service dates are within an active Hospice
period, or equal to, or greater than Hospice revocation,
and are during the month of revocation (regardless of the
Hospice Override Code), bypass this edit.

If Demonstration Number '30' is present on the claim,
bypass this edit.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 176
______________________________________________________________________________

 If Part B claim contains one of the following CPT Codes
 '59840', '59841', '59850', '59851', '59852', '59855',
 '59856', '59857', or '59866' with a 'G7' Modifier with
 Dates of Service 10/01/1998, or later, bypass this edit.

 If Demonstration Number '38' is present on the claim,
 bypass this edit.

 If the claim contains a 'QV' Modifier in all details and
 the Date of Service is on or after 09/19/2000, bypass this
 edit.

 If the claim contains a 'Q1' Modifier in all details and
 the Date of Service is on or after 01/01/2008, and risk
 HMO and Dates of Service are during the HMO period and
 the Deductible Indicator is '1' on all detail lines;
 Bypass this edit

 If the claim contains a 'KZ' Modifier and the Date of
 Service is on or after 10/01/2003, bypass this edit.

 When the Claim Payment Denial Indicator is equal to '0',
 bypass this edit.

 When the From Date equals the Hospice Start Date
 bypass this edit.

 When the HMO Option Code is '4', bypass this edit.

 Trailer Information: 08


 b. Error Code:    5232     ( )New (X)Modified ( )Deleted
 Disposition:      UR

 Type of Record:   DMEPOS

 Error Message:
 Services overlap GHO Entitlement and no edit is present
 in the Detail Override Edit Table.

 OR

 Services overlap Choices/ESRD Managed Care Demonstration
 entitlement and the Choices/ESRD ID Number is not present.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 177
______________________________________________________________________________

Set Condition for edit '5232':
When the claim Dates of Service overlap an ESRD or CHOICES
GHO period, and the claim GHO number is not a valid CHOICES
or ESRD ID, set the '5232' error code.

When the Plan ID is for Choices or ESRD, and override code
is present, set the '5232' error code.

When the claim Dates of Service overlap a non-ESRD or
CHOICES GHO period, and the claim GHO number does not match
the GHO number on the Beneficiary master record, or does
not exist, and the header Override Code table does not
indicate '5232', set the '5232' error code.

If the claim Dates of Service are within a GHO period, and
the claim Dates of Service are also within a Hospice
period, and the header Override Code table does indicate
'5232', bypass this edit.

If the Beneficiary is enrolled in both GHO and Hospice,
bypass this edit.

If the claim service dates are within an active Hospice
period, or equal to, or greater than Hospice revocation,
and are during the month of revocation (regardless of the
Hospice Override Code), bypass this edit.

If Demonstration Number '30' is present on the claim,
bypass this edit.

If Part B claim contains one of the following CPT Codes
'59840', '59841', '59850', '59851', '59852', '59855',
'59857', or '59866' with a 'G7' Modifier with
Dates of Service 10/01/1998, or later, bypass this edit.

If Demonstration Number '38' is present on the claim,
bypass this edit.

If the claim contains a 'QV' Modifier in all details and
the Date of Service is on or after 09/19/2000, bypass this
edit.

If the claim contains a 'QR' Modifier in all details and
the Date of Service is on or after 03/20/2006, bypass this
edit.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 178
______________________________________________________________________________

 If the claim contains a 'KZ' Modifier and the Date of
 Service is on or after 10/01/2003, bypass this edit.

 When the Claim Payment Denial Indicator is equal to '0',
 bypass this edit.

 When the From Date equals the Hospice Start Date
 bypass this edit.

 When the HMO Option Code is '4' bypass this edit.

 If the claim contains a 'Q0' Modifier in all details and
 the Date of Service is on or after 01/01/2008, and risk
 HMO and Dates of Service are during the HMO period and
 the Deductible Indicator is '1' on all detail lines;
 Bypass this edit

 If the claim contains a 'Q1' Modifier in all details and
 the Date of Service is on or after 01/01/2008, and risk
 HMO and Dates of Service are during the HMO period and
 the Deductible Indicator is '1' on all detail lines;
 Bypass this edit

 Trailer Information: 05, 08


 c. Error Code:    5270   ( )New (X)Modified ( )Deleted
 Disposition:      UR

 Type of Record:   Pt. B Carrier

 Error Message:
 The Beneficiary is a risk HMO with a
 Modifier 'QV' and the Deductible
 Indicator is not '1'.

 OR

 The Beneficiary is a risk HMO and Modifier
 'QV' is present, but not on all detail lines.

 Set Condition for edit '5270':

 When the HUBC record is with Modifier 'QV' and Deductible
 Indicator is not '1' and Beneficiary does have a GHO AUX
 file or Dates of Service are during risk GHO period and
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 179
______________________________________________________________________________

 Dates of Service are on or after 09/19/2000;
 Set the '5270' error code.

 When the HUBC record is with Modifier 'KZ' and Deductible
 Indicator is not '1' and Beneficiary does have a GHO AUX
 file or DOS are during risk GHO period and DOS are
 10/01/2003 and after (unless the HCPCS code is listed
 below in the bypass logic for this edit), set the '5270'
 error code.

 When the HUBC record has lines with Modifier 'QV', but not
 all lines have the Modifier 'QV' and Deductible Indicator
 is not '1' and Beneficiary does have a GHO AUX file or DOS
 are during risk GHO period and DOS are on or after
 09/19/2000, set the '5270' error code.

 When the HUBC record has lines with Modifier 'Q1', but not
 all lines have the Modifier 'Q1' and Deductible Indicator
 is not '1' and Beneficiary does have a GHO AUX file or DOS
 are during risk GHO period and Dates of Service are on or
 after 01/01/2008;
 Set the '5270' error code.

 When the HUBC record is with Modifier 'QV' and Deductible
 Indicator is '1' and DOS are during risk HMO period and
 DOS are on or after 09/19/2000, bypass this edit.

 When the HUBC record is with Modifier 'Q1' and Deductible
 Indicator is '1' and DOS are during risk HMO period and
 Dates of Service are on or after 01/01/2008;
 Bypass this edit.

 When the HUBC record is with Modifier 'QV' and Deductible
 Indicator is not '1' and Beneficiary does not have a GHO
 Aux file or DOS are not during risk GHO period and DOS are
 on or after 09/19/2000, bypass this edit.

 When the HUBC record is with Modifier 'QV' and Deductible
 Indicator is not '1' and Beneficiary does have a GHO AUX
 file or DOS are during risk GHO period and DOS are prior
 to 09/19/2000, bypass this edit.

 When the claim is denied in the header, bypass this edit.

 When the HUBC record has a Modifier 'KZ' and the
 deductible indicator is not a '1' and the Beneficiary
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 180
______________________________________________________________________________

has a GHO Aux File or the Dates of Service are on or
after 01/01/2006, and a HCPCS code of '33249', bypass
this edit.

When the HUBC record is with Modifier 'KZ' and the
deductible indicator is not a '1' and the Beneficiary does
have an GHO Aux File or the Dates of Service are on or
after 01/01/2005, and one of the HCPCS codes are '32491'
or '33979', bypass this edit.

When the HUBC record with Modifier 'Q1' on all detail lines
and Deductible Indicator is not '1' on all detail lines
and the Date of Service is equal to or greater than 01/01/2008
and is during risk GHO period with Risk HMO,
set the '5270' edit.

Trailer Information:       '08'


d. Error Code:    5270     ( )New (X)Modified ( )Deleted
Disposition:      UR

Type of Record:   DMEPOS

Error Message:
The Beneficiary is a risk HMO with a Modifier 'QV' and
the Deductible Indicator is not '1'.

OR

The Beneficiary is a risk HMO and Modifier 'QV' is present,
but not on all detail lines.

OR

The Beneficiary is a risk HMO with a Modifier 'QR' and the
Deductible Indicator is not '1'.

OR

The Beneficiary is a risk HMO and Modifier 'QR' is present,
but not on all detail lines.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 181
______________________________________________________________________________

 Set Condition for edit '5270': Under development

 When the HUDC record contains Modifier 'QV' and Deductible
 Indicator is not '1' and DOS are during risk HMO period and
 DOS are on or after 09/19/2000, set the '5270' error code.

 When the HUDC record contains Modifier 'QV' and Deductible
 Indicator is '1' and DOS are during risk HMO period and DOS
 are on or after 09/19/2000, bypass this edit.

 When the HUDC record contains Modifier 'QV' and Deductible
 Indicator is not '1' and Beneficiary does not have a HMO AUX
 file or DOS are not during risk HMO period and DOS are on or
 after 09/19/2000, bypass this edit.

 When the HUDC record contains Modifier 'QV' and Deductible
 Indicator is not '1' and Beneficiary does have a HMO AUX file
 and DOS are during risk HMO period and DOS are prior to
 09/19/2000, bypass this edit.

 When the HUDC record contains Modifier 'QR' and Deductible
 Indicator is not '1' and DOS are during risk HMO period and
 DOS are on or after 03/20/2006, set the '5270' error code.

 When the HUDC record contains Modifier 'QR' and Deductible
 Indicator is '1' and DOS are during risk HMO period and DOS
 are on or after 03/20/2006, bypass this edit.

 When the HUDC record contains Modifier 'QR' and Deductible
 Indicator is not '1' and Beneficiary does not have a HMO AUX
 file or DOS are not during risk HMO period and DOS are on or
 after 03/20/2006, bypass this edit.

 When the HUDC record contains Modifier 'QR' and Deductible
 Indicator is not '1' and Beneficiary does have a HMO AUX file
 and DOS are during risk HMO period and DOS are prior to
 03/20/2006, bypass this edit.

 When the HUBC record with Modifier 'Q0' on all detail lines
 and Deductible Indicator is not '1' on all detail lines
 and the Date of Service is equal to or greater than 01/01/2008
 and is during risk GHO period with Risk HMO,
 Set this 5270 edit.

 When the HUBC record with Modifier 'Q0' on all detail lines
 and Deductible Indicator is not '1' on all detail lines
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 182
______________________________________________________________________________

 and the Date of Service is equal to or greater than 01/01/2008
 and is during risk GHO period with Risk HMO;
 Set this 5270 edit.

 Trailer Information:   '08'

   INSTALLATION INSTRUCTIONS:   None

   SYSTEMS DOCUMENTATION AFFECTED:

     EDITUTIL             ADD MODIFIER 'QO' FOR 01/01/2008 TO
                          '5232' FOR PART B.

     EDITUTIL             ADD MODIFIER 'QO' FOR 01/01/2008 TO
                          '5270' FOR PART B.

     EDITUTIL             ADD MODIFIER 'QO' AND 'Q1' FOR 01/01/2008
                          TO '5232' FOR DMERC.

     EDITUTIL             ADD MODIFIER 'QO' AND 'Q1' FOR 01/01/2008
                          TO '5270' FOR DMERC.

   SATELLITE SYSTEM MODIFICATIONS:     None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 183
______________________________________________________________________________

  16. 00025675   5804 DME NCB ADDENDUM TO PHASE V FOR PHYSICIANS/PRACTITIONER

  REQUESTOR ID: CWFM2000

  IMPACT:
(X) Host
( ) Satellite Part A Inpatient
( ) Satellite Part A Outpatient
( ) Satellite Part B
( ) Hospice
( ) Home Health
(X) DMERC

  REASON FOR CHANGE:
CWF will be modified to accept competitive bidding program Modifier
'KV' effective 01/01/2008. The new 'KV' Modifier (DMEPOS item
subject to DMEPOS competitive bidding program that is furnished as
part of a professional service) will be used to identify claims
for DME items subject to the physician and treating practitioner
exception.

CWF will create a new edit that will set on an HUDC record with a
'KV' Modifier, a NCB indicator and a matching office visit is not
found in Part B history.

NOTE:   This change will be implemented on 04/07/2008.

  NEW BUSINESS REQUIREMENTS:

Requirement 1
CWF will create a new A/B crossover edit '7552' (No Matching
office Visit) to set when an incoming HUDC record is submitted
with 'KV' Modifier, NCB indicator of 'Y' and no matching office
visit (99201-99357) (paid or denied) is found in history with
the same Date of Service as the incoming NCB detail line item.

For rental claims (TOS R) this edit will set only
on the first rental claim. To determine if the rental claim
is the first rental, CWF will read the HUDC claim history
to determine if the same HCPCS is posted with a date within 60
days of the incoming record. If there is no claim posted within
60 days, consider the incoming to be the first rental claim.

Do not set the edit if not the first rental claim.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 184
______________________________________________________________________________

 If the record has TOS 'P' for Purchase, search for the matching
 Part B office visit.

 CWF will only return Trailers '08' and '39' for the new edit.
 This edit will not set on denied line items.

 Requirement 2
 Edit '7552' will be overridden when identified in the detail line
 override field of the HUDC.

 Requirement 3
 CWF will return Trailer '39' on the detail line level for new
 crossover edit '7552'. Trailer '39' will identify all detail lines
 that caused the HUDC to reject.

   EVENT-RESPONSE LIST:

 Event 1.1
 An HUDC (initial rental month) is submitted with 'KV'
 Modifier and NCB indicator of 'Y'. There is no office
 visit (paid or denied) present in history with the same
 Date of Service.

 Response
 A/B crossover edit '7552' is set.

 Event 1.2
 An HUDC (initial rental month) claim is submitted with 'KV'
 Modifier and NCB indicator of 'Y'. There is an office visit
 present (paid or denied) in history with the same Date of Service.

 Response
 A/B crossover edit '7552' is not set.

 Event 1.3
 An HUDC claim (subsequent rental month) is submitted with 'KV'
 Modifier and NCB indicator of 'Y'. There is no office visit
 (paid or denied) present in history with the same Date of Service.

 Response
 A/B crossover edit '7552' is not set.

 Event 1.4
 An HUDC purchase claim is submitted with 'KV' Modifier and
 NCB indicator of 'Y'. There is no office visit (paid or denied)
 present in history with the same Date of Service.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 185
______________________________________________________________________________


 Response
 A/B crossover edit '7552' is set.

 Event 1.5
 An HUDC purchase claim is submitted with 'KV' Modifier
 and NCB indicator of 'Y'. There is an office visit (paid
 or denied) present in history with the same Date of Service.

 Response
 A/B crossover edit '7552' is not set.

 Event 2.1
 An HUDC claim is submitted that receives A/B crossover edit
 '7552'. The detail override field contains '7552'.

 Response
 A/B crossover edit '7552' is not set.

 Event 2.2
 An HUDC claim is submitted that received A/B crossover edit
 '7552'. The detail override field does not contain '7552'.

 Response
 A/B crossover edit '7552' is set.

 Event 3.1
 An HUDC claim is submitted that will set A/B crossover
 edit '7552'.

 Response
 Crossover edit '7552' is set. A '39' Trailer is returned
 that identifies the detail line item which caused the claim
 to reject. Trailer '08' will also be returned.

 The Entity List includes only NEW acronyms and terminology
 that is currently not in use in CWF.

 Entity List: N/A

 Areas Affected by the Problem.
   1. A/B Crossover

 Solution Criteria: N/A


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 186
______________________________________________________________________________

   EDITS AFFECTED:

 a. Error Code:      7552   (X)New ( )Modified ( )Deleted
 Disposition: CR

 Type of Record:     Pt. B Carrier

 Error Message:
 An HUDC claim is submitted with 'KV' Modifier and NCB
 indicator of 'Y' and there is no office visit (paid
 or denied) present in history with the same Date of
 Service.

 Set Condition for edit '7552':
 An incoming HUDC claim contains a 'KV' Modifier and an
 NCB Indicator set to 'Y', there is no paid or denied
 Office Visit (HCPCS 99201-99357) in history with the
 same Date of Service, set the 7552 edit.

 When the Type of Service is 'P' (Purchase) and there
 is a paid or denied Office Visit in History with the
 same Date of Service, bypass the 7552 edit.

 When the Type of Service is 'R' (Rental) and there
 is no paid or denied Office Visit in History with the
 same Date of Service, and the incoming HUDC claim is
 not the First Rental, bypass the 7552 edit.

 Trailer Information: 08, 39

   INSTALLATION INSTRUCTIONS:      None

   SYSTEMS DOCUMENTATION AFFECTED:

     EDITABX                 NEW CROSSOVER EDIT '7552' FOR HUDC TRANS.

     EDITLIST                NEW CROSSOVER EDIT '7552' FOR HUDC TRANS.

   SATELLITE SYSTEM MODIFICATIONS:        None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 187
______________________________________________________________________________

   17. 00025694   5779-NATIONAL COMPETITIVE BIDDING (NCB) PHASE V

   REQUESTOR ID: CWFM2000

   IMPACT:
 (X) Host
 ( ) Satellite Part A Inpatient
 ( ) Satellite Part A Outpatient
 ( ) Satellite Part B
 ( ) Hospice
 ( ) Home Health
 (X) DMERC

   REASON FOR CHANGE:
 The Medicare Modernization Act (MMA) mandates competitive bidding
 programs to replace the current DMEPOS fee schedule payment
 amounts for selected items.

 CWF will need to make modifications to accept, transmit and
 display the new indicator that designates an HUDC or HUCM
 transaction as being subject to NCB. CWF will not perform any
 editing on the new data.

 CWF will also allow a maximum of 45 payments for Oxygen and
 25 payments for capped rental items for NCB claims.

 Oxygen HCPCS:
 (E0424, E0431, E0439, E0434, E0441-E0444, E1390-E1392, K0738.)

 Capped Rental HCPCS:
 (E0193, E0250, E0251, E0255, E0256, E0260, E0261, E0265, E0266
 E0277, E0290-E0297, E0301-E0305, E0316, E0371-E0373,
 E0470-E0472, E0601, E0910-E0912, E2402, K0813-K0816,
 K0820-K0829, K0835-K0843, K0848-K0864.)

 Modification will be required to edit 'C022' (Invalid Medical
 Necessity Length) to allow up to 45 payments for oxygen.
 Utilization edit 'D903' (Purchase Option or Rental Cap has
 been met) will need to modified also to allow up to 25 payments
 for the capped rental HCPCS listed above. CWF will read Paid
 Claim History to count the services.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 188
______________________________________________________________________________

   NEW BUSINESS REQUIREMENTS:

 Requirement 1
 CWF will add one one-byte new National Competitive Billing (NCB)
 indicator field to the HUDC transmit record to CWF (CABEHUBC) that
 will designate a claim as being subject to NCB. Only the
 value of 'Y' in the field will indicate the claim as being
 subject to NCB. The new indicator field will be present at the
 line level.

 Requirement 2
 CWF will add one one-byte new National Competitive Billing (NCB)
 indicator field to the HUCM transmit record to CWF (CABEHUCM)
 that will designate the HUCM transaction as being subject to NCB.
 Only the value of 'Y' in the field will indicate the transaction
 as being subject to NCB.

 Requirement 3
 CWF will add one one-byte new National Competitive Billing (NCB)
 indicator field on the line level to the NCH record (CABEHIBC)
 for HUDC transactions.

 Requirement 4
 CWF will add the new National Competitive Billing (NCB)
 indicator field on the line level to the ITF screens
 for HIDC. (CICSMAP HIDCM02).

 DMEPOS CLAIM                                   TRANSID    HIDC
 LINE ITEM INFORMATION: (NOTE: THE SYSTEM WILL ACCEPT 1 THRU 13 LINES)
 CMS-SUPPLIER-TYPE X CMS-TYPE-SERVICE X     CMS-SUPP-SPECIALTY XX
 CMS-ASSIGN-IND X CMS-PAY-PROC-IND X        CMS-REIMB-IND X CMS-DED-IND
 PROCEDURE-CODE XXXXX MODFIERS XX XX        SUSP-DUP-REV-IND    TT    TR
 CMS-PAY-SCREEN-IND X           SUBMITTED-CHARGES XXXXXX     WAIVER-LIAB
 ALLOWED-CHARGES XXXXX SUPPLIER-TAX-NUM XXXXXX SCREEN-SUSPEND-IND XXXX
 SCREEN-RESULT-IND X DECISION-IND X SUPP-STATE-CODE XX PLACE-OF-SERV
 SPECIALTY-PRICING-IND X SERV-FROM-DT XXXXX SERV-THRU-DT XXXXX
 SUPPLIER XXXXXXX      NPI-IND   GRP NPI                 NUM-OF-ITEMS 001
 DIAGNOSIS XXXX   SCREEN-SAVE 0000000 PURCH-ALLOW 0008183 ACTION-CODE S
 NATL-DRUG-CD              UNITS 0000000000 NPI-SUPPLIER
 UNITS-IND 3 DOCUMENT-IND 1 TOT-PAT-REIMB 0000000 TOT-SUPP-REIMB 00065
 TOT-CASH-DED-APP 00000 TOT-MSP-APP 0000000
 MSP-CD    OTH-AMTS-APP - FLD1 0000000 FLD2 0000000 FLD3 0000000 FLD4 000
 FLD5 0000000 OTH-AMTS-IND - IND1 N IND2 N IND3 N IND4 N IND5 N
 PART-B-COIN 0001637 STATE-CODE KS NOC-CODE               ==> NCB-IND <==
 OVERRIDE EDIT1:       EDIT2:      EDIT3:      EDIT4:       EDIT5:

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 189
______________________________________________________________________________

 Requirement 5
 CWF will add the new National Competitive Billing (NCB)
 indicator field to the ITF screens for HICM (CICSMAP HICMM01).

 HICM / HICMINTT                                                     12/05/07
                             (CMN MAINTENANCE TRANSACTION)            11:29:13

  HICN:   725694100A    CONTRACTOR NUMBER: 00885       CONTROL NBR: TEST 1

  LAST NAME: SARGE      FIRST INITIAL: G    DOB: 11 / 10 / 1920       SEX:
  APPROVED HCPCS: A5500 SUBMITTED HCPCS: _____     DMEPOS CATEGORY: 9
  CERT TYPE: 1       TRANS TYPE: 1                  REPLACEMENT: _
  INITIAL CERT DATE: 12 / 01 / 01             RECERT DATE:    /     /
  SCHED RECERT:          /    /          DISCONTINUE DATE:    /     /
  DIAG CODE 1: 41409 2: _____ 3: _____ 4: _____ LAST SEEN:      /     /
  NECESSITY LENGTH: 12                                 RESIDENCE: 12
  ORDERING PHYSICIAN / UPIN: A12345 NPI:             SURNAME: CASEY
  SUPPLIER / ID: 998877      NPI:        TYPE SERVICE: J INIT: B NCBIND:<=
  DELIVERY DATE: 01 / 01 / 00         WARRANTY INDICATOR: N LENGTH:        T

 Requirement 6
 CWF will add the new National Competitive Billing (NCB)
 indicator field to the line level DMEH HIMR screen (CICSMAP HMRMDE4).

 DMEH                          DMEPOS CLAIM HISTORY                 PAGE     3

 ICN 25073-1.1.1-4     LINE01 OF 01 ENTRY CD 1 CLM FROM 08/05/05 CLM THRU 0
 FROM/THRU PL/TOS HCPCS MOD        DIAG ITEMS UNITS/IND           SUB/ALLOW CHG
 08/05/05    12     K0002 RR KJ 7812 001                1.000         88.00
 08/05/05    R                                        3               81.83
 SPECIALTY PRICING IND D NPI SUPP                  SUPPLIER         4779300004
 TOTAL PAT REIMB              TT        TR         SUPP TAX NUMBER 4319877173
 TOTAL SUPP REIMB      65.46                       SUPPLIER TYPE    3
 CASH DED APPLIED                                  SUPP SPECIALTY 54
 CO INS                16.37 SUSP DUP REV IND      SUPPLIER STATE KS
 SCREEN SUS IND 1511 SCREEN RES IND E SCREEN SVGS                   DECISION IN
 NDC               NOC DESC                     RES STATE KS DME PURCHASE
 MSP APPLIED      0.00    MS    WAIVER N ACT CODE SW      DOC IND 1 NCBIND Y<==
 OTHER AMTS APPLIED 1:             2:        3:            4:           5:
 OTHER AMTS IND      1: N          2: N      3: N          4: N         5: N
 CMS: ASSIGNMENT 3 PAY PROCESS A        REIMB 0 DED 0 PAY SCREEN 9
 OVERRIDE EDIT1:         EDIT2:       EDIT3:        EDIT4:       EDIT5:




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 190
______________________________________________________________________________

 Requirement 7
 CWF will add the new National Competitive Billing (NCB)
 indicator field to the detail in the CMNAUX HIMR screen
 (CICSMAP HMRMCN2).

 CMND                              CMN DETAIL                     PAGE    1
 HIC 725694100A                     LOCAL HOST               DOB 11/10/1920
 CORR 725694100A      NAME                                   DOD            S
 CMN 3
                      INP 0000 OUT 0000 HOS 0000 PTB 0000 DME 0000 HHA 000

 HCPCS A5500 INIT CERT DT 120101 END DT 120102 ST         CAT 9 SKLTN
 CARRIER 00885 DT CREATED 112807 DT UPDATED             SUB HCPCS _____
 CUM MN 12 REC/REV 00 USEFUL LIFE            MAINT DATE           RNT SRV
 PUR: DEC    DT         AMT      0.00 RNT: SUP                AMT         0.
 NXT SCH RC          DIAG 41409                     LST SEEN           MN
 ORD UPIN A12345   ORD NAME B CASEY          SUP NO 998877        PTRS 12
 DELIVERY DT 010100 REPLACE _ WARRANTY: IND N LEN 00 TYP _
 NPI ORD PHY UPIN            NPI SUPPLIER         ==> NCBIND <==
 RC/RV DT         TYPE __ ST _ NPI OPU __________ NPI SUPP __________
 CARRIER _____ DT CREATED           DT UPDATED          DISCONTINUE DATE
 NXT SCH RC          DIAG _____ _____ _____ _____ LST SEEN             MN
 ORD UPIN ______   ORD NAME _ _____________ SUP NO __________ PTRS __
 RC/RV DT         TYPE __ ST _ NPI OPU __________ NPI SUPP __________
 CARRIER _____ DT CREATED           DT UPDATED          DISCONTINUE DATE
 NXT SCH RC          DIAG _____ _____ _____ _____ LST SEEN             MN
  ORD UPIN ______   ORD NAME _ _____________ SUP NO __________ PTRS __

 Requirement 8
 CWF will add the new National Competitive Billing (NCB)
 indicator field to the HUDC claim history on the
 Beneficiary record (CIOCPTB).

 (CIOCPTB is an internal CWF copybook.)

 Requirement 9
 CWF will add the new National Competitive Billing (NCB)
 indicator field for the physical claim record for the
 CMN Auxiliary file on the Beneficiary Master Record (CABCCMN).

 Requirement 10
 CWF will modify edit 'C022' (Invalid Medical Necessity Length)
 to allow up to 45 months when a HUCM is submitted with Oxygen
 HCPCS (E0424, E0431, E0439, E0434, E0441-E0444, E1390-E1392)
 and the NCB indicator on the HUCM is equal to 'Y'.
 CWF will modify edit 'C022' to allow up to 25 months when a
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 191
______________________________________________________________________________

 HUCM is submitted with Capped Rental HCPCS code
 E0193, E0250, E0251, E0255, E0256, E0260, E0261, E0265, E0266
 E0277, E0290-E0297, E0301-E0305, E0316, E0371-E0373,
 E0470-E0472, E0601, E0910-E0912, E2402, K0813-K0816,
 K0820-K0829, K0835-K0843, K0848-K0864
 and the NCM indicator on the HUCM is equal to 'Y'.

 Requirement 11
 CWF will not be applying any modifications to edit D903 for
 oxygen services that will allow up to 45 months.
 NOTE: To prevent D903 for the following HCPCS (E0424, E0431, E0439,
 E0434, E0441-E0444, E1390-E1392) the end date on the existing
 occurrences on the CMN Aux file will require the contractor to
 to update the CMN in CWF to allow up to 45 months or the claim
 will continue to set D903 based on the posted end date.
 For HCPCS K0738 that does not require a CMN, there will be no changes
 made for D903 by CWF at this time. For this HCPC PCHL is read to
 calculate the rental services. CWF only maintains 36 months and
 expanding PCH to maintain more than this will require major changes
 that will be addressed by CMS.
 (The 45 months will be calculated based on Date of Service
 01/01/2006 and after.)

 Requirement 12
 CWF will modify edit 'D903' (rental cap has been met)
 to allow a maximum of 25 payments when NCB indicator is
 present with a 'Y'. CWF will read PCHL to determine if the
 claim has the NCB indicator present and allow additional payment
 based on Dates of Service 01/01/2006 and after.

   EVENT-RESPONSE LIST:

 Event 1.1
 An HUDC claim is submitted with a 'Y' in the new National Competitive
 Billing indicator field.

 Response
 The HUDC claim is accepted.

 Event 2.1
 An HUCM transaction is submitted with a 'Y' in the new National
 Competitive Billing indicator field.

 Response
 The HUCM transaction is accepted.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 192
______________________________________________________________________________

 Event 3.1
 An HUDC claim is submitted and there is data in the National
 Competitive Billing (NCB) indicator field.

 Response
 The HUDC claim is accepted and the NCH record (CABEHIBC)
 is populated with the National Competitive Billing (NCB) indicator data.

 Event 4.1
 An HUDC claim is submitted with National Competitive Billing (NCB) data
 and entered into the Internal Testing Facility (ITF).

 Response
 The HUDC record is accepted.

 Event 5.1
 An HUCM transaction is submitted with National Competitive Billing (NCB)
 data and entered into the Internal Testing Facility (ITF).

 Response
 The HUCM transaction is accepted.

 Event 6.1
 An HUDC claim is submitted with National Competitive Billing (NCB)
 indicator data.

 Response
 The National Competitive Billing (NCB) indicator data is shown on the
 DMEH HIMR screen.

 Event 7.1
 An HUCM transaction is submitted with National Competitive Billing (NCB)
 indicator data.

 Response
 The National Competitive Billing (NCB) indicator data is shown on the
 CMN auxiliary HIMR detail screen.

 Event 8.1
 An HUDC claim with National Competitive Billing (NCB) indicator data
 is submitted.

 Response
 The National Competitive Billing (NCB) indicator data is present on the
 DME claim history Beneficiary record.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 193
______________________________________________________________________________

Event 9.1
An HUCM transaction with National Competitive Billing (NCB)
indicator data is submitted.

Response
The National Competitive Billing (NCB) indicator data is present on the
CMN claim history Beneficiary record.

Event 10.1
An HUCM transaction is submitted with an oxygen HCPCS, NCB indicator
of 'Y' and medical necessity length of '45' or less.

Response
Edit 'C022' is not set.

Event 10.2
An HUCM transaction is submitted with an oxygen HCPCS, NCB indicator
of 'Y' and medical necessity length of '46' or greater.

Response
Edit 'C022' is set.

Event 10.3
An HUCM transaction is submitted with an oxygen HCPCS, medical necessity
length greater than '36' and NCB indicator of 'Y' is not present.

Response
Edit 'C022' is set.

Event 11.1 ***Pending CMS instruction***
An HUDC claim is submitted with HCPCS 'K0738' and NCB
indicator of 'Y'. PCHL is read. The incoming claim is the
16th or greater rental service; but not greater than the 45th
rental services.

Response
Edit 'D903' is not set.

Event 11.2 ***Pending CMS instruction***
An HUDC claim is submitted with HCPCS 'K0738' and NCB
indicator of 'Y'. PCHL is read. The incoming claim is the
46th or greater rental service.

Response
Edit 'D903' is set.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 194
______________________________________________________________________________

Event 11.3 ***Pending CMS Instruction***
An HUDC claim is submitted with HCPCS 'K0738' and no NCB indicator.
The incoming claim is the 16th or greater rental service.

Response
Edit 'D903' is set.

Event 12.1
An HUDC claim is submitted with a capped rental HCPCS and NCB
indicator of 'Y'. PCHL is read. The incoming claim is the
16th or greater rental service; but not greater than 25th rental
service.

Response
Edit 'D903' is not set.

Event 12.2
An HUDC claim is submitted with a capped rental HCPCS and NCB
indicator of 'Y'. PCHL is read. The incoming claim is the
26th or greater rental month.

Response
Edit 'D903' is set.

Event 12.3
An HUDC claim is submitted with a capped rental HCPCS and no NCB
indicator. The incoming claim is the 16th or greater rental service.

Response
Edit 'D903' is set.

The Entity List includes only NEW acronyms and terminology
that is currently not in use in CWF.

Entity List: N/A

Areas   Affected by the Problem.
  1.    Transmit records (HUDC, HUCM)
  2.    ITF (HIDC, HICM)
  3.    Claim History
  4.    HIMR (DMEH, CMND)
  5.    NCH (HUDC, HUCM)
  6.    DME utilization (C022, D903)

Solution Criteria: N/A

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 195
______________________________________________________________________________

   EDITS AFFECTED:

 a. Error Code: C022    ( )New (X)Modified ( )Deleted
 Disposition: CM

 Type of Record: HUCM

 Error Message:
 Invalid Medical Necessity Length.

 Set Condition for edit 'C022': Under Development

       Required for:
             DMEPOS Category = ALL
             Cert. Type      = ALL
             Trans Type      = '1'
       Format:
             Numeric
 Valid Values:
      '00' thru '99'.

      Must be '00-15' or '99', if Category is '4' and
      Cert. Type is '2' or '3'.

      Must be '00-13', or '99', if Category is '4' and
      Init. Cert. Date is on or after 01/01/2006 and
      Cert. Type is '2' or '3'.

      Must be '01-15' or '99', if Category is '4' and
      Cert. Type is '1'.

      Must be '01-13', or '99', if Category is '4' and
      Init. Cert. Date is on or after 01/01/2006 and
      Cert. Type is '1'.

      Must be '00-99' if Category is '6' and Cert. Type
      is '2' or '3'.

      Must be '01-99' if Category is '6' and Cert.
      Type is '1'.

      Must be '00-15' or '99', for PEN pumps, and must
      be '03-99' for other PEN items if Category is '7'
      and Cert. Type is '2' or '3'.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 196
______________________________________________________________________________

     Must be '01-15' or '99', for PEN pumps, and must
     be '03-99' for other PEN items if Category is '7'
     and Cert. Type is '1'.

     Must be '01-99' if Category is '5' and
     Init. Cert. Date is before 01/01/2006 and Cert.
     Type is '2' or '3' and the following HCPCS codes:

      E0441 - Stationary gaseous contents used with
              patient owned gaseous stationary system.
      E0442 - Stationary liquid contents used with
              patient owned liquid stationary system.
      E0443 - Portable gaseous contents used with
              patient owned gaseous portable system.
      E0444 - Portable liquid contents used with
              patient owned liquid portable system.

      Must be '01-99' if Category is '5', certification
      type is '1'and Init. Cert. Date is before
      01/01/2006 and for the following HCPCS codes:

      E0441 - Stationary gaseous contents used with
              patient owned gaseous stationary system.
      E0442 - Stationary liquid contents used with
              patient owned liquid stationary system.
      E0443 - Portable gaseous contents used with
              patient owned gaseous portable system.
      E0444 - Portable liquid contents used with
              patient owned liquid portable system.

     Must be '01-36' if Category is '5' and
     Init. Cert. Date is on or after 01/01/2006 and
     certification type is '2' or '3' and the following
     HCPCS codes:

     E0424   -Stationary gaseous oxygen system.
     E0431   -Portable gaseous oxygen system.
     E0434   -Portable liquid oxygen system.
     E0439   -Stationary liquid oxygen system.
     E1390   -Oxygen concentrator, single delivery
              port.
      E1391 - Oxygen concentrator, dual delivery port.
      E1405 - Oxygen and water vapor enriching system
      E1392 - Portable oxygen concentrator.
              with heated delivery.
      E1406 - Oxygen and water vapor enriching system
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 197
______________________________________________________________________________

             without heated delivery.
     K0738 - Home compressor used to fill portable
             oxygen system.

 Must be '01-36' if Category is '5' and
 Init. Cert. Date is on or after 01/01/2006 and
 certification type is '1' and the following
 HCPCS codes:

     E0424   -   Stationary gaseous oxygen system.
     E0431   -   Portable gaseous oxygen system.
     E0434   -   Portable liquid oxygen system.
     E0439   -   Stationary liquid oxygen system.
     E1390   -   Oxygen concentrator, single delivery
                 patient owned liquid stationary system.
     E1391 -     Oxygen concentrator, dual delivery port.
     E1392 -     Portable oxygen concentrator.
     E1405 -     Oxygen and water vapor enriching system
                 with heated delivery.
     E1406 -     Oxygen and water vapor enriching system
                 without heated delivery.
     K0738 -     Home compressor used to fill portable
                 oxygen system.

 When the CMN medical necessity length is equal to spaces,
 zeros, low values, or alphabetic, and the CMN medical
 certification type is not equal to '2' or '3', set the 'C022'
 error code.

 When the CMN medical necessity length is numeric, and VALID-
 LENGTH is true, and the CMN DMEPOS category is equal to '4',
 and VALID-PPUMP-RENT is not true, set the 'C022' error code.

 When the CMN medical necessity length is numeric, and VALID-
 LENGTH is true, and the CMN DMEPOS category is equal to '6',
 and VALID-CAT6 is not true, set the 'C022' error code.

 When the CMN medical necessity length is numeric, and VALID-
 LENGTH is true, and the CMN DMEPOS category is equal to '5',
 and VALID-CAT5 is not true, set the 'C022' error code.

 When the CMN medical necessity length is numeric, and VALID-
 LENGTH is true, and the CMN DMEPOS category is equal to '7',
 and POSCAT-PEN-PUMP is true, and VALID-PPUMP-RENT is not
 true, set the 'C022' error code.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 198
______________________________________________________________________________

 When the CMN medical necessity length is numeric, and VALID-
 LENGTH is true, and the CMN DMEPOS category is equal to '7',
 and POSCAT-PEN-PUMP is not true, and the CMN medical
 necessity length is less than '3', set the 'C022' error
 code.

 When the CMN medical necessity length is numeric, and VALID-
 LENGTH is not true, set the 'C022' error code.

 When the CMN medical necessity length is not numeric, set
 the 'C022' error code.

 When the CMN transaction type is equal to '3', bypass this
 edit.

 Trailer Information: 08


 b. Error Code: D903       ( )New (X)Modified ( )Deleted
 Disposition: UR

 Type of Record: HUDC

 Error Message:
 For HCPCS that require a CMN (Category 59):
 Capped Rental, Electric Wheelchair and PEN pump claims
 (without the 'MS' or 'RP' Modifiers) are not allowed once the
 purchase option or rental cap has been met. CHOICES and ESRD
 Managed Care Demonstration claims are not subject to this
 edit under these circumstances.

 For HCPCS that do not require a CMN (Non-Category 59):
 Paid Claims History (PCH) indicates that the rental cap has
 been met for a Category '1' or Category '5' HCPCS code and
 claims with these HCPCS are not allowed once the rental
 cap has been met. CHOICES and ESRD Managed Care
 Demonstration claims are subject to this edit under these
 circumstances. When the Line Item Edit Override Table has
 a 'D903' present, bypass this edit.

 Set Condition for edit 'D903': Under development
 When the Procedure Code is in Category '1' or '5' and
 does not require a CMN (Non-Category 59), set the 'D903'
 error code as follows:


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 199
______________________________________________________________________________

   - When the number of services for a Home compressor used
     to fill portable oxygen system (HCPCS K0738)
     with the billing date's after 01/01/2006 that
     is not equal to '36', set the 'D903' error
     code.

   - When the number of services for a capped rental or
     power wheelchair DME with the earliest billing date
     prior to 01/01/2006 exceeds '15', set the 'D903' error
     code.

   - When the number of services for a capped rental or
     power wheelchair DME with the earliest billing date on
     or after 01/01/2006 exceeds '13', set the 'D903' error
     code.

 When the Certificate of Medical Necessity Purchase
 Decision is equal to 'P' or 'R', and the purchase date is
 greater than zero, and the claim line item From or Thru Date
 is greater than the purchase date, set the 'D903' error code.

 When the CMN is a skeleton record, bypass this edit.

 When the claim is CHOICES or ESRD claim, bypass this edit.

 When there are no existing matching CMN records, and HCPCS
 Edit Category '1', '5', or '10' is true, and the Procedure
 Code Modifiers '1', '2', '3', or '4' is equal to the
 maintenance service Modifier, bypass this edit.

 When the Certificate of Medical Necessity National Drug Claim
 Indicator is equal to high values, bypass this edit.
 There are specific editing criteria when counting the number
 of rental services. These edits are performed in HICMNDEL:

   -   The number of services are counted by the number
       of rentals in an ascending Date of Service
       sequence where the Thru Date of Service is within
       sixty-one days of the next From Date of Service.
       (The gap in Rental services must not be greater
       than 60-days), bypass this edit.

   -   For HCPCS 'E0471' and 'E0472' the start of the
       calculation of (13) rental services for these
       HCPCS begins 04/01/2006 and after on the PCHL.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 200
______________________________________________________________________________

 Note: If the interruption is greater than 60 consecutive days
 the number of rental services begins counting at '1'
 and the process continues.

   -     The From Date of Service on the current claim
         must be within a calculated Start-Date and End-Date.
         The Start-Date is 2.5 years prior to the
         date. The Start-Date is 2.5 years prior to the
         current date and End-Date is the current date,
         bypass this edit.

   -     If the HCPCS code has changed, the rental
         services are no longer accumulated for this
         claim, bypass this edit.

 Trailer Information:    08, 16

   INSTALLATION INSTRUCTIONS:     None

   SYSTEMS DOCUMENTATION AFFECTED:

       COPYXTNL             ADD FIELDS FOR NCB IND TO CABEHUBC.

       DATA DICTIONARY      ADD FIELDS FOR NCB IND TO CABEHUBC.
                            ADD FIELDS FOR NCB IND ON ITF SCREEN.

       COPYXTNL             ADD FIELDS FOR NCB IND TO CABEHUCM.

       DATA DICTIONARY      ADD FIELD FOR NCB IND TO CABEHUCM.

       EDITMNTS             MODIFY HUCM EDIT 'C022'.

       EDITUTIL             MODIFY HUDC EDIT 'D903'.

   SATELLITE SYSTEM MODIFICATIONS:       None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 201
______________________________________________________________________________

      18. 00025699   DOCUMENTATION CHANGES FOR RELEASE R2008200

      REQUESTOR ID: CWFM1000

   IMPACT:
 (X) Host
 (X) Satellite Part A Inpatient
 (X) Satellite Part A Outpatient
 (X) Satellite Part B
 (X) RHHI
 (X) Home Health
 (X) DMERC

   REASON FOR CHANGE:
 Make documentation updates that are not associated with a CR in the
 R2008200 release and communicate them to the users.

   NEW BUSINESS REQUIREMENTS:
 The documentation updates that are not associated with a CR in the
 R2008200 release are listed below:

 1.    DOCUMENTATION UPDATE REQUESTED:
       ASSOCIATED CR:
       ASSOCIATED DOC ONLY:
       ASSOCIATED RELEASE:
       REQUESTED DATE: 10/11/2007
       REQUESTED BY: Debby Kocovinos
       PHONE NUMBER: 443-436-6706
       LOCATION OF CHANGE(S): All Sections

       DESCRIPTION OF CHANGE(S):
       Fix all grammar, punctuation, upper/lower case
       issues throughout the documentation.


 2.    DOCUMENTATION UPDATE REQUESTED:
       ASSOCIATED CR:
       ASSOCIATED DOC ONLY:
       ASSOCIATED RELEASE:
       REQUESTED DATE: 01/03/2008
       REQUESTED BY:   Debby Kocovinos
       PHONE NUMBER:   443-436-6706
       LOCATION OF CHANGE(S): COPYINPR



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 202
______________________________________________________________________________

      DESCRIPTION OF CHANGE(S):
      Change the header in CABCFFSD copybook section from
      CABCHCPI to CABCFFSD.


 3.   DOCUMENTATION UPDATE REQUESTED:
      ASSOCIATED CR: 00025689
      ASSOCIATED DOC ONLY:
      ASSOCIATED RELEASE: R2008100
      REQUESTED DATE: 01/11/2008
      REQUESTED BY: Margarita Podyachev
      PHONE NUMBER: 443-436-6608
      LOCATION OF CHANGE(S): COPYXTNL

      DESCRIPTION OF CHANGE(S):
      Modify CABEHUQA layouts.


 4.   DOCUMENTATION UPDATE REQUESTED:
      ASSOCIATED CR:
      ASSOCIATED DOC ONLY:
      ASSOCIATED RELEASE:
      REQUESTED DATE: 01/24/2008
      REQUESTED BY: Vicki Sommers
      PHONE NUMBER: 469-372-7642
      LOCATION OF CHANGE(S): EDITCONS

      DESCRIPTION OF CHANGE(S):
      Deactivate '76x1'.


 5.   DOCUMENTATION UPDATE REQUESTED:
      ASSOCIATED CR:
      ASSOCIATED DOC ONLY:
      ASSOCIATED RELEASE:
      REQUESTED DATE: 01/24/2008
      REQUESTED BY: Vicki Sommers
      PHONE NUMBER: 469-372-7642
      LOCATION OF CHANGE(S): TABLECO

      DESCRIPTION OF CHANGE(S):
      Deactivate '76x1'.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 203
______________________________________________________________________________

 6.    DOCUMENTATION UPDATE REQUESTED:
       ASSOCIATED CR: 00025566
       ASSOCIATED DOC ONLY:
       ASSOCIATED RELEASE: R2008100
       REQUESTED DATE: 01/25/2008
       REQUESTED BY: Vicki Sommers
       PHONE NUMBER: 469-372-7642
       LOCATION OF CHANGE(S): EDITALRT

       DESCRIPTION OF CHANGE(S):
       Add new IUR codes '524P and '524Q'.


 7.    DOCUMENTATION UPDATE REQUESTED:
       ASSOCIATED CR:
       ASSOCIATED DOC ONLY:
       ASSOCIATED RELEASE:
       REQUESTED DATE: 01/22/2008
       REQUESTED BY: Vicki Sommers
       PHONE NUMBER: 469-372-7642
       LOCATION OF CHANGE(S): COPYXTNL

       DESCRIPTION OF CHANGE(S):
       Remove incorrect Trailer information.


 8.    DOCUMENTATION UPDATE REQUESTED:
       ASSOCIATED CR: 00021821
       ASSOCIATED DOC ONLY:
       ASSOCIATED RELEASE: R2003300
       REQUESTED DATE: 2/22/2008
       REQUESTED BY: Vicki Sommers
       PHONE NUMBER: 469-372-7642
       LOCATION OF CHANGE(S): EDITUTIL

       DESCRIPTION OF CHANGE(S):
       Include correct wording for edit '5232' on DMEPOS
       due to CR 00021821 (CMS CR 2363).

      EVENT-RESPONSE LIST:     None

      EDITS AFFECTED:   None

      INSTALLATION INSTRUCTIONS:      None


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 204
______________________________________________________________________________

  SYSTEMS DOCUMENTATION AFFECTED:   See above

  SATELLITE SYSTEM MODIFICATIONS:   None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 205
______________________________________________________________________________

   19. 00025700   R2008200 INSTALLATION INSTRUCTION - ONE-TIMER CONTROL CR

   REQUESTOR ID: CWFM1000

   IMPACT:
 (X) Host
 (X) Satellite Part A Inpatient
 (X) Satellite Part A Outpatient
 (X) Satellite Part B
 (X) RHHI
 (X) Home Health
 (X) DMERC

   REASON FOR CHANGE:
 This CR will track one-timers and Installation Instructions for
 the R2008200 Release. Host and Satellites should refer to the
 R2008200 Release Documentation Appendix A for information
 concerning interdependencies and timing of these jobs.

   NEW BUSINESS REQUIREMENTS:

 Requirement 1
 One-Timer Job Name:   UTLJ81A0
 Originating CR:       00025640
 Run by Host/Satl:     Host
 Files Prod/Test:      Prod/Test
 Purpose of Job:       Expand VISNAUX file key and length

 Requirement 2
 One-Timer Job Name:   UTLJ82B0
 Originating CR:       00025718
 Run by Host/Satl:     Host
 Files Prod/Test:      Prod/Test
 Purpose of Job:       Initialize the NEW NPI field and increase the
                       length of HHEHAUX file from 3685 TO 4045.

 Requirement 3
 One-Timer Job Name:   UTLJ82C0
 Originating CR:       00025718
 Run by Host/Satl:     Host
 Files Prod/Test:      Prod/Test
 Purpose of Job:       Initialize the NEW NPI field of HCHE records
                       in CABHICR file.



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 206
______________________________________________________________________________

 Requirement 4
 One-Timer Job Name:    CABHCPC
 Originating CR:        00025786
 Run by Host/Satl:      Host
 Files Prod/Test:       Prod/Test
 Purpose of Job:        Load the HCPCS Table

   EVENT-RESPONSE LIST:       None

   EDITS AFFECTED:     None

   INSTALLATION INSTRUCTIONS:

  **********************************************************
  ***********   REQUIREMENT 1 INSTRUCTIONS    **************
  ***********           CR 00025640           **************
  **********************************************************

  A. Conversion
     This section notes the type of file that is being created

     _X__    Production File Conversion
     _X__    Test File Conversion

     This section notes who converts the file:

     _X__    Beta File Conversion
     _X__    Host File Conversion
     ____    Satellite File Conversion

  B. Timing Considerations
     Jobs UTLJ82A0 must be run after the installation
     of the R2008200 release software and before the first
     cycle using the R2008200 release software.

  C. Requirement
     Modify the UTLJ82A0 execution JCL provided with the
     R2008200 release to meet the requirements of your
     site.

     The execution JCL can be found in the '*.R2008200.H.SW.UTILLIB',
     member UTLJ82A0.

  D. Important Notes
     UTLJ82A0 must be run with files closed.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 207
______________________________________________________________________________

  E. Installation Steps

    Jobs UTLJ82A0 is run to expand the key and file lengths
    of the VISNAUX file.

    1) Insure that The VISNAUX file is closed in the region.

    2) Execute the job, UTLJ82A0

        a) DELETE step Deletes all working datasets.
        b) BACKUP1 step Repros the VSAM VISNAUX file into a flat
           file.
        c) UTLS82A0 step expands VISNAUX key length from 11 to
           14 bytes and the length to 2097 bytes.
        d) DELDEF step will delete/define VSAM VISNAUX file.
        e) RELOAD1 will repro the new expanded sequential file to
           the VSAM file.
        f) All counts are displayed on Sysout.

    3) Open all files in the region.


  **********************************************************
  ***********   REQUIREMENT 2 INSTRUCTIONS    **************
  ***********         CR 00025718             **************
  **********************************************************

  A. Conversion
     This section notes the type of file that is being created

    _X__     Production File Conversion
    _X__     Test File Conversion

    This section notes who converts the file:

    _X__     Beta File Conversion
    _X__     Host File Conversion
    ____     Satellite File Conversion

  B. Timing Considerations
     Jobs UTLJ82B0 must be run after the installation
     of the R2008200 release software and before the first
     cycle using the R2008200 release software.



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 208
______________________________________________________________________________

 C. Requirement
    Modify the UTLJ82B0 execution JCL provided with the
    R2008200 release to meet the requirements of your site.

    The execution JCL can be found in the '*.R2008200.H.SW.UTILLIB',
    member UTLJ82B0.

 D. Important Notes

    1) PARM1 in the JCL has been setup to use for TEST or
       PRODUCTION runs.

       PARM1='T' - Use when running in TEST mode
                   no HHEHAUX file updates are done
                   Steps DELDEF and RELOAD1 are not executed

       PARM1='P' - Use when running in PROD mode
                   HHEHAUX file updates are done

    2) UTLJ82B0 must be run with HHEHAUX file closed.

 E. Installation Steps
    Job UTLJ82B0 is run to initialize the new NPI field in HHEHAUX
    file and to increase the length of HHEHAUX file from 3685 to 4045
    bytes.

    1) Ensure that the HHEHAUX file is closed in the region.

    2) Execute the job, UTLJ82B0

          A) DELETE Step deletes all working datasets.
          B) BACKUP1 step repros the VSAM HHEHAUX file into a flat
             file
          C) UTLJ82B0 step to initialize the new NPI field in HHEHAUX
             file and to increase the length of HHEHAUX file from
             3685 to 4045 bytes
          D) DELDEF step will delete/define VSAM HHEHAUX file.
          E) RELOAD1 will repro the new expanded sequential file to
             the VSAM file.
          F) All counts are displayed on SYSOUT.

    3) Open HHEHAUX file in the region.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 209
______________________________________________________________________________

  **********************************************************
  ***********   REQUIREMENT 3 INSTRUCTIONS    **************
  ***********           CR 00025718           **************
  **********************************************************

  A. Conversion
     This section notes the type of file that is being created

    ____     Production File Conversion
    _X__     Test File Conversion

    This section notes who converts the file:

    _X__     Beta File Conversion
    _X__     Host File Conversion
    ____     Satellite File Conversion

  B. Timing Considerations
     Jobs UTLJ82C0 must be run after the installation
     of the R2008200 release software and before the first
     cycle using the R2008200 release software.

  C. Requirement
     Modify the UTLJ82C0 execution JCL provided with the
     R2008200 release to meet the requirements of your
     site.

    The execution JCL can be found in the '*.R2008200.H.SW.UTILLIB',
    member UTLJ82C0.

  D. Important Notes

    1) UTLJ82C0 must be run only in test regions to convert the
       existing HCHE records in CABHICR file.

    2) PARM1 in the JCL has been setup to use for TEST or
       PRODUCTION runs.

        PARM1='T' - Use when running in TEST mode
                    no CABHICR file updates are done
                    steps DELDEF and RELOAD1 are not executed

        PARM1='P' - Use when running in PROD mode
                    CABHICR file updates are done

     2) UTLJ82C0 must be run with CABHICR file closed.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 210
______________________________________________________________________________


  E. Installation Steps
     Job UTLJ82C0 is run to initialize the new NPI field of HCHE
     records in CABHICR file.

    1) Ensure that the CABHICR file is closed in the region.

    2) Execute the job, UTLJ82C0

            A) DELETE Step deletes all working datasets.
            B) BACKUP1 step repros the VSAM CABHICR file into a flat
               file
            C) UTLJ82C0 step to initialize the new NPI field of HCHE
               records in CABHICR file.
            D) DELDEF step will delete/define VSAM CABHICR file.
            E) RELOAD1 will repro the new expanded sequential file to
               the VSAM file.
            F) All counts are displayed on SYSOUT.

    3) Open CABHICR file in the region.


  **********************************************************
  ***********   REQUIREMENT 4 INSTRUCTIONS    **************
  ***********           CR 00025786           **************
  **********************************************************

  The conversion and timing considerations, followed by the
  requirement, important notes, and installation steps are
  listed below.

  A. Conversion
     This section indicates the type of file affected:
     (Note - Mark ALL that apply with an "X")

    __X_     Production File Conversion
    __X_     Test File Conversion

     This section identifies who converts the file:
     (Note - Mark ALL that apply with an "X")

     __X_     Beta File Conversion
     __X_     Host File Conversion
     ____     Satellite File Conversion


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 211
______________________________________________________________________________

 B. Timing Considerations
    Load the HCPCS Table before the first cycle using the
    Release software.

 C. Requirement
    Update the HCPCS Table.

 D. Important Notes
    None.

 E. Installation Steps
    Load the HCPCS Table using the INITHCPC utility.

  SYSTEMS DOCUMENTATION AFFECTED:   None

  SATELLITE SYSTEM MODIFICATIONS:   None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 212
______________________________________________________________________________

   20. 00025701     EXTERNAL COPYBOOK CHANGES FOR R2008200

   REQUESTOR ID: CWFM1000

   IMPACT:
 (X) Host
 (X) Satellite Part A Inpatient
 (X) Satellite Part A Outpatient
 (X) Satellite Part B
 (X) RHHI
 (X) DMERC

   REASON FOR CHANGE:
 Make external copybook updates that are associated with the
 CRs contained in the R2008200 Release, and communicate them
 to the Standard System Maintainers.

   NEW BUSINESS REQUIREMENTS:

  Requirement 1

  Copybook Name: CABECOIF

 These changes are associated with CRs 00025648:

           C25329       05       :XX:-MASS-ADJUSTMENTS-MPFS    PIC   X(01).
           C25329       05       :XX:-MASS-ADJUSTMENTS-OTHER   PIC   X(01).
 >>>>>>>   C25648       05       :XX:-ALL-ADJUSTMENTS          PIC   X(01).
 >>>>>>>   C25648       05       FILLER                        PIC   X(03).


  Requirement 2

  Copybook Name: CABEHUBC

 These changes are associated with CRs 00025660, 00025694 and 00025598:

           C24325 01    :XB:-RECORD.

           C24325       05       :XB:-HEADER.
                             .
                             .
                             .
           C25329         10 :XB:-CLAIM-ADJ-IND       PIC X(01).
           C25329           88 :XB:-CLAIM-ADJ-VALID VALUE 'A' 'N'
           C25329                                           SPACE.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 213
______________________________________________________________________________

           C25329                   88    :XB:-CLAIM-ADJ       VALUE 'A'.
           C25329                   88    :XB:-CLAIM-NON-ADJ   VALUE 'N'.
           C24325
 >>>>>>>   C25660              10    :XB:-CT-REGISTRY.
 >>>>>>>   C25660                    15 :XB:-CT-REGISTRY-NUM
 >>>>>>>   C25660                                           PIC      9(08).
 >>>>>>>   C25660              10    FILLER                 PIC      X(277).
                           .
                           .
                           .
           C24325                    15    :XB:-PRESCRIPTION.
           C24325                          20 :XB:-VENDOR-ID PIC     X(04).
           C24325                          20 :XB:-HCPCS      PIC    X(05).
           C24325                          20 :XB:-VENDOR-PR-NUM
           C24325                                             PIC    X(21).
 >>>>>>>   C25694                    15    :XD:-NCB-IND       PIC    X(01).
 >>>>>>>   C25598                    15    :XB:-TEST-TYPE     PIC    X(02).
 >>>>>>>   C25598                    15    :XB:-TEST-RESULTS.
 >>>>>>>   C25598                          20 :XB:-TEST-RESULTS-N
 >>>>>>>   C25598                                             PIC    9(02)V9.
           C25598
           C24325*                   ADD NEW LINE ITEM FIELDS BEFORE THE FOLLOWI
           C24325*                   AND SUBTRACT THE APPROPRIATE NUMBER OF BYTE
           C24325*                   TO MAINTAIN EACH LINE ITEM LENGTH OF 500 BY
           C24325
 >>>>>>>   C25598                    15     FILLER             PIC   X(195).
 >>>>>>>   C25598*                   15     FILLER             PIC   X(200).


 Requirement 3

 Copybook Name: CABEHIBC

 These changes are associated with CRs 00025660, 00025694 and 00025598:

           C24325     05       :XB:-IDENT-PLUS-PARTB.
           C24325              10 :XB:-NCH-HEADER-DATA.
                                 .
                                 .
                                 .
           C25329                  15 :XB:-CLAIM-ADJ-IND    X(01).
                                                           PIC
           C25329                                           VALUE
                                       88 :XB:-CLAIM-ADJ-VALID
                                                            'A' 'N'
                                                            SPACE.
           C25329                 88 :XB:-CLAIM-ADJ         VALUE 'A'.
           C25329                 88 :XB:-CLAIM-NON-ADJ     VALUE 'N'.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 214
______________________________________________________________________________

>>>>>>>   C25660                15   :XB:-CT-REGISTRY.
>>>>>>>   C25660                     20 :XB:-CT-REGISTRY-NUM
>>>>>>>   C25660                                         PIC    9(08).
>>>>>>>   C25660                15   FILLER              PIC    X(290).
                            .
                            .
                            .
          C24325                15   :XB:-PRESCRIPTION.
          C24325                     20 :XB:-VENDOR-ID PIC     X(04).
          C24325                     20 :XB:-HCPCS      PIC    X(05).
          C24325                     20 :XB:-VENDOR-PR-NUM
          C24325                                        PIC    X(21).
>>>>>>>   C25694                15   :XD:-NCB-IND       PIC    X(01).
>>>>>>>   C25598                15   :XB:-TEST-TYPE     PIC    X(02).
>>>>>>>   C25598                15   :XB:-TEST-RESULTS.
>>>>>>>   C25598                     20 :XB:-TEST-RESULTS-N
>>>>>>>   C25598                                        PIC    9(02)V9.
          C24325
          C24325*               ADD NEW LINE ITEM FIELDS BEFORE THE FOLLOWI
          C24325*               AND SUBTRACT THE APPROPRIATE NUMBER OF BYTE
          C24325*               TO MAINTAIN EACH LINE ITEM LENGTH AT 500 BY
          C24325
>>>>>>>   C25598                15   FILLER             PIC    X(195).
>>>>>>>   C25598*               15   FILLER             PIC    X(200).
                            .
                            .
                            .


Requirement 4

Copybook Name: CABEHUCM

These changes are associated with CR 00025694:

          C24568 01 CMN-T-MAINTENANCE-RECORD.
          C24568    05 CMN-T-RECORD-TYPE               PIC X(04).
          C24568        88 SATELLITE-MAINTENANCE         VALUE 'HUCM'.
          C24568        88 OSA-MAINTENANCE               VALUE 'HBCM'.
          C24568    05                                 PIC X(01).
          C24568    .
                    .
                    .
                    .
                    .

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 215
______________________________________________________________________________

           C24568          10     CMN-T-HICR-PURCH-DEC-IND    PIC     X(01).
           C24568                 88 CMN-T-HICR-PUR-DEC-PURCH                  VALU
           C24568                 88 CMN-T-HICR-PUR-DEC-CAPPD                  VALU
           C24568
           C24568          10     CMN-T-HICR-PURCH-DATE   PIC S9(07) COMP-3.
           C24568          10     CMN-T-HICR-PURCH-AMT    PIC S9(06)V99 COMP-3.
           C24568          10     CMN-T-HICR-ALLOW-AMT    PIC S9(06)V99 COMP-3.
           C24568
 >>>>>>>   C25694     05        CMN-T-NCBIND                    PIC    X(01).
 >>>>>>>   C25694     05        FILLER                          PIC    X(88).
 >>>>>>>   C25694*    05        FILLER                          PIC    X(89).
           C24568

   EVENT-RESPONSE LIST:         None

   EDITS AFFECTED:   None

   INSTALLATION INSTRUCTIONS:          None

   SYSTEMS DOCUMENTATION AFFECTED:            None

   SATELLITE SYSTEM MODIFICATIONS:            See Above




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 216
______________________________________________________________________________

  21. 00025702   ARCHIVE MAINTENANCE FOR RELEASE R2008200

  REQUESTOR ID: CWFM1000

  IMPACT:
(X) Host
(X) Satellite Part A Inpatient
(X) Satellite Part A Outpatient
(X) Satellite Part B
( ) RHHI
( ) Home Health
( ) DMERC

  REASON FOR CHANGE:
This CR will record those CWFM configuration items that are
to be archived and/or restored with the R2008200 Release.

  NEW BUSINESS REQUIREMENTS:

Requirement 1
Archive the following SOURCE modules:

  HOST:
  -----

    CR 00025702 (R2008200 Release)
       UTLS71A0
       UTLS71B0
       UTLS71C0
       UTLS71DA
       UTLS71D0
       UTLS71E0
       UTLS71E1
       UTLS71E2
       UTLS71E3
       UTLS71E4
       UTLS71F0
       UTLS71G0
       UTLS71G1
       UTLS71G2
       UTLS72A1
       UTLS72B0
       UTLS72C0
       UTLS73C0
       UTLS74A0

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
    Common Working File                                                   R2008200
    Host Quarterly Release Document                                  March 4, 2008
    Section VII. Detailed Description of Changes                          Page 217
    ______________________________________________________________________________


     Archive the following UTILITY modules:

       HOST:
       -----

               00025702 (R2008200 Release)
               UTLJ71A0   UTLJ71GA
               UTLJ71B0   UTLJ71G0
               UTLJ71C0   UTLJ71G1
               UTLJ71DA   UTLJ71G2
               UTLJ71D0   UTLJ71G3
               UTLJ71D1   UTLJ71G4
               UTLJ71D2   UTLJ71G5
               UTLJ71D3   UTLJ71G6
               UTLJ71D4   UTLJ71G7
               UTLJ71D5   UTLJ71G8
               UTLJ71D6   UTLJ71G9
               UTLJ71D7   UTLJ72A1
               UTLJ71D8   UTLJ72B0
               UTLJ71D9   UTLJ72C0
               UTLJ71EA   UTLJ72C1
               UTLJ71EB   UTLJ72C2
               UTLJ71E0   UTLJ72C3
               UTLJ71E1   UTLJ72C4
               UTLJ71E2   UTLJ72C5
               UTLJ71E3   UTLJ72C6
               UTLJ71E4   UTLJ72C7
               UTLJ71E5   UTLJ72C8
               UTLJ71E6   UTLJ72C9
               UTLJ71E7   UTLJ73A0
               UTLJ71E8   UTLJ73B0
               UTLJ71E9   UTLJ73C0
               UTLJ71F0   UTLJ74A0


     Archive the following PROC modules:

       HOST:
       -----

         CR 00025702 (R2008200 Release)
            UTLP71A0   UTLP72A1
e            UTLP71B0   UTLP72B0
            UTLP71C0   UTLP72C0
            UTLP71DA   UTLP73A0
    ______________________________________________________________________________
    2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 218
______________________________________________________________________________

          UTLP71D0   UTLP73B0
          UTLP71E0   UTLP73C0
          UTLP71E1   UTLP74A0
          UTLP71E2
          UTLP71F0
          UTLP71G0
          UTLP71G1


Archive the following CONTROL CARD modules:

  HOST:
  -----

    CR 00025702 (R2008200 Release)
       UTLC71DA
       UTLC71E0
       UTLC71E1
       UTLC71G0
       UTLC72B0

  EVENT-RESPONSE LIST:       None

  EDITS AFFECTED:     None

  INSTALLATION INSTRUCTIONS:        None

  SYSTEMS DOCUMENTATION AFFECTED:          None

  SATELLITE SYSTEM MODIFICATIONS:          None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 219
______________________________________________________________________________

   22. 00025718   5812 INCLUDE NPI FOR MBD/NGD EXTRACTS FROM CWF ON HOSP & HH

   REQUESTOR ID: CWFM2000

   IMPACT:
 (X) Host
 ( ) Satellite Part A Inpatient
 ( ) Satellite Part A Outpatient
 ( ) Satellite Part B
 (X) Hospice
 (X) Home Health
 ( ) DMERC

   REASON FOR CHANGE:
 Due to CMS CR 5014 (Addition of Data Elements to CWF Extracts
 on the Next Generation Desktop (NGD) Datamart) and CMS CR 4300
 (Common Working File (CWF) to the Medicare Beneficiary Database
 (MBD) Data Exchange Changes) two new fields for NPI were
 created for the legacy Provider Number on the Hospice Period
 and Home Health Episode. Even though these fields were created
 no data is present since the NPI fields do not exist on the
 Auxiliary Files in CWF for the Hospice Period and Home Health
 Episode where the information is carried on the extract file
 for the MBD and NGD. The NPI is only displayed on claim history
 in CWF because the number is on the submitted claim.

 CWF will carry the National Provider Identifier (NPI) on the
 transmit record to the Hospice Period and Home Health
 Episode Auxiliary Files. The NPI from the Hospice Period and
 Home Health Episode Auxiliary Files will then be carried to
 the MBD and NGD extract file from CWF.

   NEW BUSINESS REQUIREMENTS:

 Requirement 1
 CWF already carries the four new fields (10 bytes) for
 the NPI that coincides with the legacy Provider Numbers
 in the Hospice Period on the physical record for the
 Hospice Auxiliary File. However, CWF will need to add
 the four new fields (10 bytes) to the Hospice Periods
 on the HOSP Auxiliary File (HOSP) in HIMR.

 If the NOE or Hospice record is accepted in CWF and the
 NPI for the legacy Provider Number is present, CWF
 will populate the NPI also in the Hospice Period.
 The Hospice Period on the Hospice Auxiliary File (HOSP)
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 220
______________________________________________________________________________

 carries the following legacy Provider Numbers:

 a)   Prov 1
 b)   Prov 2
 c)   Change of Ownership Prov 1
 d)   Change of Ownership Prov 2

 CWF will not validate the NPI and continue to use the
 legacy Provider Number for processing Hospice.

 No modification is required to Trailer '02' to carry
 the NPI.

 No modification is required to the Provider Inquiry
 screens HIQA, HIQH, or HUQA to carry the NPI.
 This is not necessary since the screens will be
 obsolete in the near future.

 If an adjustment (Action Code 3) is accepted in CWF,
 with a different NPI than the one posted on the
 HOSP Auxiliary File, CWF will overlay the NPI.

 If a cancel (Action Code 4) is accepted in CWF and
 does not remove the Hospice Period, CWF should not
 update the NPI in the Period.

 If TOB '8xB' to revoke a Hospice Period is accepted
 and the NPI is different than the NPI in the
 Hospice Period, CWF will overlay the NPI from the
 revoked NOE.

 If TOB '8xD' to cancel a Hospice Period is accepted
 and the NPI is different than the NPI in the
 Hospice Period, CWF will cancel the Hospice Period
 and not match based on NPI.

 HIMR Screen Update for Hospice(HOSP) period:
 --------------------------------------------
                  PERIOD         OWNER CHANGE     PERIOD        OWNER CHA
 START DATE 1
 TERM DATE
 PROV 1
 NPI 1 =========> XXXXXXXXXX     XXXXXXXXXX
 INTER 1
 EARLIEST BILLING
 LATEST BILLING
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 221
______________________________________________________________________________

DAYS USED
START DATE 2
PROV 2
NPI 2 =========> XXXXXXXXXX     XXXXXXXXXX
INTER 2
DIAG CD
REVOCATION IND

Requirement 2
CWF will add one new field (10 bytes) for the NPI that
coincides with the legacy Provider Number in the Home
Health Episode on the physical record for the HH PPS
Episode Auxiliary File. If the Home Health record is
accepted in CWF and the NPI for the legacy Provider
Number is present, CWF will populate the NPI also in
the Home Health Episode on the HH PPS Episode
Auxiliary File.

CWF will not validate the NPI and continue to use the
legacy Provider Number for processing Home Health.

No modification is required to Trailer '23' to carry
the NPI.

No modification is required to the Provider Inquiry
screen HIQH or HUQA to carry the NPI. This is not
necessary since the screens will be obsolete in
the near future.

If an adjustment (Action Code 3) is accepted in CWF,
with a different NPI than the one posted on the
HHEH Auxiliary File, CWF will overlay the NPI.

If a cancel (Action Code 4) is accepted in CWF that
does not remove the Home Health Episode and the
NPI is different than the NPI in the Home Health
Episode, CWF will not update the NPI.

If the Home Health Episode is posted in CWF and a
Final or LUPA is accepted with a different NPI,
CWF will update the NPI for the episode.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 222
______________________________________________________________________________

 CABCHHEH Copybook:
 ------------------
 New 10 bytes NPI field will be added to CABCHHEH copybook.
 CABCHHEH is the copybook layout for Home Health Episode
 Auxiliary file.

 The new NPI field is indicated with '=====>' in the below
 layout.

 05  :XX:-EPISODE-PERIODS.
     10 :XX:-EPISODE-PERIOD-TBL
                             OCCURS 1 TO 36 TIMES
                             DEPENDING :XX:-SEGMT-COUNT
                             INDEXED   :XX:-SEG-IDX.
         15 :XX:-PPS-START-DT
                             PIC S9(07) COMP-3.
         15 :XX:-PPS-END-DT
                             PIC S9(07) COMP-3.
         15 :XX:-CONTR-NUM PIC X(05).
         15 :XX:-PROV-NUMBER.
             20 :XX:-PROV-NUM
                             PIC X(06).
             20 FILLER      PIC X(07).
 =====> 15 :XX:-NPI         PIC X(10).
         15 :XX:-HRG-CODES.
             20 :XX:-HRG-DATA
                             OCCURS 6 TIMES.
                 25 :XX:-HRG-CDE
                             PIC X(05).
                 25 :XX:-HRG-DTE
                             PIC S9(07) COMP-3.
         15 :XX:-DOEBA      PIC S9(07) COMP-3.
         15 :XX:-DOLBA      PIC S9(07) COMP-3.
         15 :XX:-PRINC-DIAG
                             PIC X(05).
         15 :XX:-SECOND-DIAG
                             PIC X(05).
         15 :XX:-LUPA-IND    PIC X(01).
         15 :XX:-PAT-STATUS

 Requirement 3
 CWF will need to add one new field (10 bytes) to the
 Home Health Episode on the HH PPS Episode Auxiliary
 File (HHEH) in HIMR.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 223
______________________________________________________________________________

 HIMR Screen Update for Home Health Episode:
 -------------------------------------------
                     EPISODE             EPISODE              EPISODE
  START DATE
  END DATE
  CONTRACTOR
  PROVIDER
  NPI NUMBER ======> XXXXXXXXXX          XXXXXXXXXX           XXXXXXXXXX
  HRG CODE-DATE 1
  HRG CODE-DATE 2
  HRG CODE-DATE 3
  HRG CODE-DATE 4
  HRG CODE-DATE 5
  HRG CODE-DATE 6
  DOEBA - DOLBA
  PRIN/SECOND DIAG
  LUPA IND
  PATIENT STATUS
  CANCEL IND

 Note: Due to space problem on the screen, DOEBA and DOLBA will
       appear on the same line.

 Requirement 4
 CWF will carry the NPI from the Hospice Period on the
 Hospice Auxiliary File to the extract file for MBD
 and NGD.

 The extract files only carries Provider 1 and will carry
 the NPI from PROV 1.

 Requirement 5
 CWF will carry the NPI from the Home Health Episode on the
 HH PPS Episode Auxiliary File to the extract file for
 MBD and NGD.

 Requirement 6
 Modify the HICR transaction HCHO to add the new NPI field
 for the HOSP Auxiliary File.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 224
______________________________________________________________________________

 HICR Screen Update for Hospice period:
 --------------------------------------

  HICR / HICRC00       CWF BENEFICIARY CORRECTION FACILITY
                          HOSPICE MASTER UTILIZATION
 BENE NR:                NAME:          INIT:     DOB:            SEX:
 TYPE OF ACTION:     0 = OVERLAY 1 = DELETE

                  PERIOD         OWNER CHANGE
 START DATE 1
 TERM DATE
 PROV 1
 NPI 1 =======> XXXXXXXXXX       XXXXXXXXXX
 INTER 1
 EARLIEST BILLING
 LATEST BILLING
 DAYS USED
 START DATE 2
 PROV 2
 NPI 2 =======> XXXXXXXXXX       XXXXXXXXXX
 INTER 2
 REVOCATION IND

 KEY IN CORRECTIONS/ADDITION THEN PRESS ENTER

 Requirement 7
 Modify the HICR transaction HCHE to add the new NPI field
 for the HHEH Auxiliary File.

 HICR Screen Update for Home Health Episode:
 -------------------------------------------

 HICR / HICRC00       CWF BENEFICIARY CORRECTION FACILITY
                       HOME HEALTH EPISODE UTILIZATION
 BENE NR:                NAME:          INIT:     DOB:            SEX:
 TYPE OF ACTION:     0 = OVERLAY 1 = DELETE
                           EPISODE
 EPISODE START DATE        MM / DD / CCYY
 EPISODE END DATE          MM / DD / CCYY
 PROVIDER NUMBER
 NPI NUMBER =========>     XXXXXXXXXX
 CONTRACTOR NUMBER
 EARLIEST BILLING          MM / MM / CCYY
 LATEST BILLING            MM / DD / CCYY
 HRG CODES 1,2,3
 HRG DATES 1,2,3           MM / DD / CCYY    MM / DD / CCYY     MM / DD /
______________________________________________________________________________
2020 Company, LLC                                           Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 225
______________________________________________________________________________

 HRG CODES 4,5,6
 HRG DATES 4,5,6             MM / DD / CCYY    MM / DD / CCYY   MM / DD /
 PRIN DIAG
 SECOND DIAG
 LUPA IND
 PATIENT STATUS
 CANCEL IND

 KEY IN CORRECTIONS AND THEN PRESS ENTER

 CABCHCHE Copybook:
 ------------------
 New 10 bytes NPI field will be added to CABCHCHE copybook.
 CABCHCHE is the copybook layout for Home Health Episode
 HICR transaction HCHE.

 The new NPI field is indicated with '=====>' in the below
 layout.

 05   HCHE-TRAILERS.
      10 HCHE-EPISODE-PERIOD PIC      9(03).
      10 HCHE-EPISODE-NUMBER PIC      9(03).

      10   HCHE-EPISODE-PERIOD-TBL.
           15 HCHE-PPS-START-DT
                               PIC S9(07) COMP-3.
           15 HCHE-PPS-END-DT PIC S9(07) COMP-3.
           15 HCHE-CONTR-NUM PIC X(05).

           15   HCHE-PROV-NUMBER.
                20 HCHE-PROV-NUM
                                PIC   X(06).
                20              PIC   X(07).

 =====>    15   HCHE-NPI        PIC X(10).
           15   HCHE-HRG-CODES.
                20 HCHE-HRG-DATA
                                OCCURS 6 TIMES
                                INDEXED HCHE-INDEX.
                    25 HCHE-HRG-CDE
                                PIC X(05).
                    25 HCHE-HRG-DTE
                                PIC S9(07) COMP-3.

         15 HCHE-DOEBA       PIC S9(07) COMP-3.
         15 HCHE-DOLBA       PIC S9(07) COMP-3.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 226
______________________________________________________________________________

           15   HCHE-PRINC-DIAG PIC    X(05).
           15   HCHE-SECOND-DIAG
                                 PIC   X(05).
           15   HCHE-LUPA-IND    PIC   X(01).
           15   HCHE-PAT-STATUS PIC    X(02).
           15   HCHE-CANCEL-IND PIC    X(01).

 Requirement 8
 Modify the HICR Audit Report AUDITRPT for HCHO to display
 the new NPI fields for the Hospice Period.

 REPORT
 DATE: 99/99/9999                           H I C R     A U D I T   R E P O R T
    USERID: 9999999
    DATE/TIME: 99999999999
    TRANSID: HCHO
    HIC NUMBER: 9999999999
                                                PRIOR               AFTER
        HOSP START DATE 1
        HOSP TERM DATE
        HOSP PROVIDER NUM 1
 ===>   HOSP NPI NUM 1
        HOSP INTERMEDIARY NUM 1
        HOSP OWNER START DTE NUM 1
        HOSP OWNER PROVIDER NUM 1
 ===>   HOSP NPI OWNERSHIP 1
        HOSP OWNER INTERMED NUM 1
        HOSPICE PERIOD
        HOSPICE DOEBA
        HOSPICE DOLBA
        HOSPICE DAYS USED
        HOSP START DATE 2
        HOSP PROVIDER NUM 2
 ===>   HOSP NPI NUM 2
        HOSP INTERMEDIARY NUM 2
        HOSP OWNER START DTE NUM 2
        HOSP OWNER PROVIDER NUM 2
 ===>   HOSP NPI OWNERSHIP 2
        HOSP OWNER INTERMED NUM 2

 Requirement 9
 Modify the HICR Audit Report AUDITRPT for HCHE to display
 the new NPI field for the HH PPS Episode.



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 227
______________________________________________________________________________

REPORT
DATE: 99/99/9999                       H I C R   A U D I T   R E P O R T
   USERID: 9999999
   DATE/TIME: 99999999999
   TRANSID: HCHE
   HIC NUMBER: 9999999999
                                         PRIOR                AFTER
     HH   EPISODE   START DATE
     HH   EPISODE   END DATE
     HH   EPISODE   CONTR NUM
     HH   EPISODE   PROV NUM
===> HH   EPISODE   NPI NUM
     HH   EPISODE   HRG CODE1
     HH   EPISODE   HRG DATE1
     HH   EPISODE   HRG CODE2
     HH   EPISODE   HRG DATE2
     HH   EPISODE   HRG CODE3
     HH   EPISODE   HRG DATE3
     HH   EPISODE   HRG CODE4
     HH   EPISODE   HRG DATE4
     HH   EPISODE   HRG CODE5
     HH   EPISODE   HRG DATE5
     HH   EPISODE   HRG CODE6
     HH   EPISODE   HRG DATE6
     HH   EPISODE   DOEBA
     HH   EPISODE   DOLBA
     HH   EPISODE   PRINC DIAG
     HH   EPISODE   SECON DIAG
     HH   EPISODE   LUPA IND
     HH   EPISODE   PAT STATUS
     HH   EPISODE   CANCEL IND

Requirement 10
Modify the XREF process for the HOSP Auxiliary File
to ensure the new field for NPI is also merged correctly.
The current process still applies when to update the
active HICs Auxiliary File for HOSP.

Requirement 11
Modify the XREF process for the HHEH Auxiliary File
to ensure the new field for NPI is also merged correctly.
The current process still applies when to update the
active HICs Auxiliary File for HHEH.



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 228
______________________________________________________________________________

 Requirement 12
 Create a one timer for HHEHAUX file conversion since the
 file length will change.

   EVENT-RESPONSE LIST:

 Event 1.1
 Submit an initial NOE TOB '8xA' (HUHC) that also carries
 the NPI for the legacy Provider Number.
 The NOE is accepted in CWF.

 Response
 The HOSP Auxiliary File displays the NPI with PROV 1 in
 the Hospice Period on the HOSP Aux File in HIMR.

 Event 1.2
 Submit a Change in Provider NOE TOB '8xC' (HUHC) that also
 carries the NPI for the legacy Provider Number.
 The NOE is accepted in CWF.

 Response
 The HOSP Auxiliary File displays the NPI with PROV 2 in
 the Hospice Period on the HOSP Aux File in HIMR.

 Event 1.3
 Submit a Change of Ownership NOE TOB '8xE' (HUHC) that also
 carries the NPI for the legacy Provider Number.
 The NOE is accepted in CWF.

 Response
 The HOSP Auxiliary File displays the NPI with PROV 1 or
 PROV 2 under Owner Change in the Hospice Period on the
 HOSP Aux File in HIMR.

 Event 1.4
 Submit a Hospice Claim TOB '8x1' (HUHC) that also carries
 the NPI for the legacy Provider Number.
 The record will create a subsequent Hospice Period.

 Response
 The HOSP Auxiliary File displays the NPI with PROV 1 in
 the new Hospice Period in HIMR.

 Event 1.5
 Submit an adjustment (AC 3) for HUHC that also carries
 a different NPI that is posted on the Hospice Period.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 229
______________________________________________________________________________


Response
The HOSP Auxiliary File overlays the NPI with PROV 1 in
the new Hospice Period in HIMR.

Event 1.6
Submit a cancel (AC 4) for HUHC that does not remove
the Hospice Period and the cancel has a different NPI
then the NPI in the Hospice Period.

Response
The HOSP Auxiliary File does not overlay the NPI.

Event 1.7
Submit TOB '8xB' to revoke a Hospice Period and is accepted.
The NPI is different than the NPI in the Hospice Period.

Response
The HOSP Auxiliary File does overlay the NPI.

Event 1.8
Submit TOB '8xD' to cancel a Hospice Period and is accepted.
The NPI is different than the NPI in the Hospice Period.

Response
The HOSP Period is removed and is not based on the NPI.

Event 2.1
Submit a Home Health RAP TOB '3x2' (HUHH) that also carries
the NPI for the legacy Provider Number.
The record is accepted in CWF.

Response
The HHEH Auxiliary File populates the NPI in the HH PPS
Episode on the physical record.

Event 2.2
Submit an adjustment (AC 3) for HUHH that also carries
a different NPI that is posted on the Home Health
Episode.

Response
The HHEH Auxiliary File overlays the NPI in the episode.



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 230
______________________________________________________________________________

 Event 2.3
 Submit a cancel (AC 4) for HUHH that does not remove
 the episode and the NPI is different than the
 NPI on the episode.

 Response
 The HHEH Auxiliary File does not update the NPI in the
 episode.

 Event 2.4
 Submit a Final or LUPA for HUHH that also carries
 a different NPI that is posted on the Home Health
 Episode.

 Response
 The HHEH Auxiliary File overlays the NPI in the episode.

 Event 3.1
 Submit a Home Health RAP TOB '3x2' (HUHH) that also carries
 the NPI for the legacy Provider Number.
 The record is accepted in CWF.

 Response
 The HHEH Auxiliary File displays the NPI in the HH PPS
 Episode in HIMR.

 Event 4.1
 An extract file for the MBD and NGD is created for a
 Beneficiary where the NPI is displayed on the HOSP
 Auxiliary File.

 Response
 The extract file for MBD and NGD displays the NPI
 for the Hospice Period.

 Event 5.1
 An extract file for the MBD and NGD is created for a
 Beneficiary where the NPI is displayed on the HHEH
 Auxiliary File.

 Response
 The extract file for MBD and NGD displays the NPI
 for the Home Health Episode.



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 231
______________________________________________________________________________

 Event 6.1
 Submit a HICR transaction for HCHO that displays the
 new NPI fields for the HOSPICE Period.

 Response
 The HICR transaction is accepted with the new NPI fields.

 Event 7.1
 Submit a HICR transaction for HCHE that displays the
 new NPI field for the HH PPS Episode.

 Response
 The HICR transaction is accepted with the new NPI field.

 Event 8.1
 The HICR transaction for HCHO is accepted for a Beneficiary.

 Response
 The HICR Audit Report displays the new NPI fields.

 Event 9.1
 The HICR transaction for HCHE is accepted for a Beneficiary.

 Response
 The HICR Audit Report displays the new NPI field.

 Event 10.1
 Submit a XREF Merge for an inactive HIC with a HOSP Auxiliary
 File and the NPI fields are present.

 Response
 The XREF Merge is successful and merges the data from the
 inactive HIC to the active HIC.

 Event 11.1
 Submit a XREF Merge for an inactive HIC with a HHEH Auxiliary
 File and the NPI field is present.

 Response
 The XREF Merge is successful and merges the data from the
 inactive HIC to the active HIC.

 Event 12.1
 Submit a one timer conversion on all Beneficiary Master
 Records for the HHEH Auxiliary File.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 232
______________________________________________________________________________

 Response
 The conversion is complete and updates the HHEH Auxiliary
 File successfully.

 The Entity List includes only NEW acronyms and terminology
 that is currently not in use in CWF.

 Entity List: N/A

 Areas Affected by the Problem.
   1. Hospice Auxiliary File
   2. HH PPS Episode Auxiliary File
   3. MBD extract file
   4. NGD extract file
   5. HICR transactions
   6. HICR Audit Report AUDITRPT

 Solution Criteria: N/A

   EDITS AFFECTED:   None

   INSTALLATION INSTRUCTIONS:

 ** See CR 00025700 for Installation Instructions for this CR. **

   SYSTEMS DOCUMENTATION AFFECTED:

     OVERHIMR               ADD NPI TO HOSP AND HHEH AUX FILES.

     SCRHOST                ADD NPI FIELD TO HICR TRANSACTIONS HCHO AND
                            HCHE.

   SATELLITE SYSTEM MODIFICATIONS:    None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 233
______________________________________________________________________________

  23. 00025786   5900 NEW K CODE FOR REPLACEMENT INTERFACE MATERIAL

  REQUESTOR ID: CWFM2000

  IMPACT:
(X) Host
( ) Satellite Part A Inpatient
(X) Satellite Part A Outpatient
( ) Satellite Part B
( ) Hospice
(X) Home Health
(X) DMERC

  REASON FOR CHANGE:
Effective 04/01/2008, a new 'K' code will be established
for replacement interface material. The new code will be
'K0672' and will have Type of Service 'P' and CWF Categories
'3' and '60'.

CWF will make modifications to consistency edit '6912' (Invalid
Revenue code, other than '0270', '0272', '0274', '0278', or
'0624' for prosthetics and orthotics) to include new code 'K0672'.

  NEW BUSINESS REQUIREMENTS:

Requirement 1
CWF must add HCPCS 'K0672' effective 04/01/2008 with Type of
Service 'P', CWF Categories '3' and '60' and the following
description:

K0672- Addition to lower extremity orthosis, removable soft
interface, replacement only, each.

Requirement 2
CWF must modify consistency edit '6912' to include new
code 'K0672'.

  EVENT-RESPONSE LIST:

Event 1.1
Access HCPI file in HIMR for new HCPCS code 'K0672'.

 Response
 HCPCS code is shown with description 'Addition to lower extremity
 orthosis, removable soft interface, replacement only, each',
 Type of Service 'P', and CWF Categories '3' and '60'.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 234
______________________________________________________________________________


 Event 2.1
 Submit an HUOP or HUHH record that contains new code 'K0672'.
 The Revenue Code is not equal to '0270', '0272', '0274', '0278',
 or '0624'.

 Response
 The claim is rejected, error code '6912' is set.

 Event 2.2
 Submit an HUOP or HUHH record that contains new code 'K0672'.
 The Revenue Code is equal to '0270', '0272', '0274', '0278',
 or '0624'.

 Response
 The record is accepted, error code '6912' is not set.

 The Entity List includes only NEW acronyms and terminology
 that is currently not in use in CWF.

 Entity List: N/A

 Areas Affected by the Problem.
   1. HCPCS module
   2. Consistency Module (HUBCCED)

 Solution Criteria: N/A

   EDITS AFFECTED:

 a. Error Code:      6912   ( )New (X)Modified ( )Deleted
 Disposition: ER

 Type of Record: HHA, OUTP

 Error Message:
 Invalid Revenue Code (other than 0270, 0272, 0274, 0278,
 or 0624) for prosthetics and orthotics.

 Set Condition for edit '6912':
 When the HCPCS code is equal to one of the values listed
 below, and the Revenue Code is not equal to '0270',
 '0272', '0274', '0278', or '0624', set the '6912' error
 code:


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 235
______________________________________________________________________________

 A4214 A4216 A4217 A4280 A4290 A4310 A4311 A4312 A4313 A4314
 A4315 A4316 A4319 A4320 A4321 A4322 A4323 A4324 A4325 A4326
 A4327 A4328 A4330 A4331 A4332 A4333 A4334 A4335 A4338 A4340
 A4344 A4346 A4347 A4349 A4351 A4352 A4353 A4354 A4355 A4356
 A4357 A4358 A4359 A4361 A4362 A4363 A4364 A4365 A4367 A4368
 A4369 A4370 A4371 A4372 A4373 A4374 A4375 A4376 A4377 A4378
 A4379 A4380 A4381 A4382 A4383 A4384 A4385 A4386 A4387 A4388
 A4214 A4216 A4217 A4280 A4290 A4310 A4311 A4312 A4313 A4314
 A4315 A4316 A4319 A4320 A4321 A4322 A4323 A4324 A4325 A4326
 A4327 A4328 A4330 A4331 A4332 A4333 A4334 A4335 A4338 A4340
 A4344 A4346 A4347 A4349 A4351 A4352 A4353 A4354 A4355 A4356
 A4357 A4358 A4359 A4361 A4362 A4363 A4364 A4365 A4367 A4368
 A4369 A4370 A4371 A4372 A4373 A4374 A4375 A4376 A4377 A4378
 A4379 A4380 A4381 A4382 A4383 A4384 A4385 A4386 A4387 A4388
 A7523 A7524 A7525 A7526 A7527 E0752 E0754 E0756
 E0757 E0758 E0759 K0112 K0113 K0556 K0557 K0558 K0559 K0561
 K0562 K0563 K0564 K0565 K0566 K0567 K0568 K0569 K0570 K0571
 K0572 K0573 K0574 K0575 K0576 K0577 K0578 K0579 K0580 K0581
 K0582 K0583 K0584 K0585 K0586 K0587 K0588 K0589 K0590 K0591
 K0592 K0593 K0634 K0635 K0636 K0637 K0638 K0639 K0640 K0641
 K0642 K0643 K0644 K0645 K0646 K0647 K0648 K0649 K0670 K0672
 K0731
 K0732 L0100 L0110 L0120 L0130 L0140 L0150 L0160 L0170 L0172
 L0174 L0180 L0190 L0200 L0210 L0220 L0300 L0310 L0315 L0317
 L0320 L0321 L0330 L0331 L0340 L0350 L0360 L0370 L0380 L0390
 L0391 L0400 L0410 L0420 L0430 L0440 L0450 L0452 L0454 L0456
 L0458 L0460 L0462 L0464 L0466 L0468 L0470 L0472 L0491 L0492
 L0610 L0620 L0621 L0622 L0623 L0624 L0625 L0626 L0627 L0628
 L0629 L0630 L0631 L0632 L0633 L0634 L0635 L0636 L0637 L0638
 L0639 L0640 L0700 L0710 L0810 L0820 L0830 L0859 L0860 L0861
 L0900 L0910 L0920 L0930 L0940 L0950 L0960 L0970 L0972 L0974
 L0976 L0978 L0980 L0982 L0984 L0986 L1000 L1001 L1005 L1010
 L1020 L1025 L1030 L1040 L1050 L1060 L1070 L1080 L1085 L1090
 L1100 L1110 L1120 L1200 L1210 L1220 L1230 L1240 L1250 L1260
 L1270 L1280 L1290 L1300 L1310 L1500 L1510 L1520 L1600 L1610
 L1620 L1630 L1640 L1650 L1652 L1660 L1680 L1685 L1686 L1690
 L1700 L1710 L1720 L1730 L1750 L1755 L1800 L1810 L1815 L1820
 L1825 L1830 L1833 L1834 L1836 L1840 L1843 L1844 L1845 L1846
 L1847 L1850 L1855 L1858 L1860 L1870 L1880 L1885 L1900 L1901
 L1902 L1904 L1906 L1907 L1910 L1920 L1930 L1932 L1940 L1945
 L1950 L1951 L1960 L1970 L1971 L1980 L1990 L2000 L2005 L2010
 L2020 L2030 L2034 L2035 L2036 L2037 L2038 L2039 L2040 L2050
 L2060 L2070 L2080 L2090 L2102 L2104 L2106 L2108 L2112 L2114
 L2116 L2122 L2124 L2126 L2128 L2132 L2134 L2136 L2180 L2182
 L2184 L2186 L2188 L2190 L2192 L2200 L2210 L2220 L2230 L2232
 L2330 L2240 L2250 L2260 L2265 L2270 L2275 L2280 L2300 L2310
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 236
______________________________________________________________________________

 L2320 L2335 L2340 L2350 L2360 L2370 L2375 L2380 L2385 L2387
 L2390 L2395 L2397 L2405 L2415 L2425 L2430 L2435 L2492 L2500
 L2510 L2520 L2525 L2526 L2530 L2540 L2550 L2570 L2580 L2600
 L2610 L2620 L2622 L2624 L2627 L2628 L2630 L2640 L2650 L2660
 L2670 L2680 L2750 L2755 L2760 L2768 L2770 L2780 L2785 L2795
 L2800 L2810 L2820 L2830 L2840 L2850 L2860 L3000 L3001 L3002
 L3003 L3010 L3020 L3030 L3031 L3040 L3050 L3060 L3070 L3080
 L3090 L3100 L3140 L3150 L3160 L3170 L3201 L3202 L3203 L3204
 L3206 L3207 L3208 L3209 L3211 L3212 L3213 L3214 L3215 L3216
 L3217 L3218 L3219 L3221 L3222 L3223 L3224 L3225 L3230 L3250
 L3251 L3252 L3253 L3254 L3255 L3257 L3260 L3265 L3300 L3310
 L3320 L3330 L3332 L3334 L3340 L3350 L3360 L3370 L3380 L3390
 L3400 L3410 L3420 L3430 L3440 L3450 L3455 L3460 L3465 L3470
 L3480 L3485 L3500 L3510 L3520 L3530 L3540 L3550 L3560 L3570
 L3580 L3590 L3595 L3600 L3610 L3620 L3630 L3640 L3650 L3651
 L3652 L3660 L3670 L3671 L3672 L3673 L3675 L3700 L3701 L3702
 L3800 L3710 L3720 L3730 L3740 L3760 L3762 L3763 L3764 L3765
 L3766 L3805 L3806 L3808 L3807 L3810 L3815 L3820 L3825 L3830
 L3835 L3840 L3845 L3850 L3855 L3860 L3890 L3900 L3901 L3902
 L3904 L3905 L3906 L3907 L3908 L3909 L3910 L3911 L3912 L3913
 L3914 L3915 L3916 L3917 L3918 L3919 L3920 L3921 L3922 L3923
 L3924 L3926 L3928 L3930 L3932 L3933 L3934 L3935 L3936 L3938
 L3940 L3942 L3944 L3946 L3948 L3950 L3952 L3954 L3956 L3960
 L3961 L3962 L3963 L3967 L3971 L3972 L3973 L3975 L3976 L3977
 L3978 L3980 L3982 L3984 L3985 L3986 L3995 L3999 L4000 L4002
 L4010 L4020 L4030 L4040 L4045 L4050 L4055 L4060 L4070 L4080
 L4090 L4100 L4110 L4130 L4350 L4360 L4370 L4380 L4386 L4392
 L4394 L4396 L4398 L5000 L5010 L5020 L5050 L5060 L5100 L5105
 L5150 L5160 L5200 L5210 L5220 L5230 L5250 L5270 L5280 L5301
 L5311 L5321 L5331 L5341 L5400 L5410 L5420 L5430 L5450 L5460
 L5500 L5505 L5510 L5520 L5530 L5535 L5540 L5560 L5570 L5580
 L5585 L5590 L5595 L5600 L5610 L5611 L5613 L5614 L5616 L5617
 L5618 L5620 L5622 L5624 L5626 L5628 L5629 L5630 L5631 L5632
 L5634 L5636 L5637 L5638 L5639 L5640 L5642 L5643 L5644 L5645
 L5646 L5647 L5648 L5649 L5650 L5651 L5652 L5653 L5654 L5655
 L5656 L5658 L5660 L5661 L5662 L5663 L5664 L5665 L5666 L5668
 L5670 L5671 L5672 L5673 L5674 L5675 L5676 L5677 L5678 L5679
 L5680 L5681 L5682 L5683 L5684 L5685 L5686 L5688 L5690 L5692
 L5694 L5695 L5696 L5697 L5698 L5699 L5700 L5701 L5702 L5703
 L5704 L5705 L5706 L5707 L5710 L5711 L5712 L5714 L5716 L5718
 L5722 L5724 L5726 L5728 L5780 L5781 L5782 L5785 L5790 L5795
 L5810 L5811 L5812 L5814 L5816 L5818 L5822 L5824 L5826 L5828
 L5830 L5840 L5845 L5846 L5847 L5848 L5850 L5855 L5856 L5857
 L5858 L5910 L5920 L5925 L5930 L5940 L5950 L5960 L5962 L5964
 L5966 L5968 L5970 L5971 L5972 L5974 L5975 L5976 L5978 L5979
 L5980 L5981 L5982 L5984 L5985 L5986 L5987 L5988 L5989 L5990
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 237
______________________________________________________________________________

L5993   L5994   L5995   L5999   L6000   L6010   L6020   L6025   L6050   L6055
L6100   L6110   L6120   L6130   L6200   L6205   L6250   L6300   L6310   L6320
L6350   L6360   L6370   L6380   L6384   L6386   L6388   L6400   L6450   L6500
L6550   L6570   L6580   L6582   L6584   L6586   L6588   L6590   L6600   L6605
L6610   L6611   L6615   L6616   L6620   L6621   L6623   L6624   L6625   L6628
L6629   L6630   L6632   L6635   L6637   L6638   L6639   L6640   L6641   L6642
L6645   L6646   L6647   L6648   L6650   L6655   L6660   L6665   L6670   L6672
L6675   L6676   L6677   L6680   L6682   L6684   L6686   L6687   L6688   L6689
L6690   L6691   L6692   L6693   L6694   L6695   L6696   L6697   L6698   L6700
L6703   L6704   L6705   L6706   L6707   L6708   L6709   L6710   L6715   L6720
L6725   L6730   L6735   L6740   L6745   L6750   L6755   L6765   L6770   L6775
L6780   L6790   L6795   L6800   L6805   L6806   L6807   L6808   L6809   L6810
L6825   L6830   L6835   L6840   L6845   L6850   L6855   L6860   L6865   L6867
L6868   L6870   L6872   L6873   L6875   L6880   L6881   L6882   L6883   L6884
L6885   L6890   L6895   L6900   L6905   L6910   L6915   L6920   L6925   L6930
L6935   L6940   L6945   L6950   L6955   L6960   L6965   L6970   L6975   L7007
L7008   L7009   L7010   L7015   L7020   L7025   L7030   L7035   L7040   L7045
L7170   L7180   L7181   L7185   L7186   L7190   L7191   L7260   L7261   L7266
L7272   L7274   L7360   L7362   L7364   L7366   L7367   L7368   L7400   L7401
L7402   L7403   L7404   L7405   L7900   L8000   L8001   L8002   L8010   L8015
L8020   L8030   L8035   L8039   L8040   L8041   L8042   L8043   L8044   L8045
L8046   L8047   L8048   L8239   L8300   L8310   L8320   L8330   L8400   L8410
L8415   L8616   L8617   L8618   L8620   L8621   L8622   L8630   L8631   L8417
L8420   L8430   L8435   L8440   L8460   L8465   L8470   L8480   L8485   L8490
L8500   L8501   L8505   L8507   L8509   L8510   L8511   L8512   L8513   L8514
L8515   L8600   L8606   L8610   L8612   L8613   L8614   L8615   L8641   L8642
L8658   L8659   L8670   L8680   L8681   L8682   L8683   L8684   L8685   L8686
L8687   L8688   L8689   L8690   L8691   L8695   L8699   Q0480   Q0481   Q0482
Q0483   Q0484   Q0485   Q0486   Q0487   Q0488   Q0489   Q0490   Q0491   Q0492
Q0493   Q0494   Q0495   Q0496   Q0497   Q0498   Q0499   Q0500   Q0501   Q0502
Q0503   Q0504   Q0505   V2020   V2100   V2101   V2102   V2103   V2104   V2105
V2106   V2107   V2108   V2109   V2110   V2111   V2112   V2113   V2114   V2115
V2116   V2117   V2118   V2121   V2200   V2201   V2202   V2203   V2204   V2205
V2206   V2207   V2208   V2209   V2210   V2211   V2212   V2213   V2214   V2215
V2216   V2217   V2218   V2219   V2220   V2221   V2300   V2301   V2302   V2303
V2304   V2305   V2306   V2307   V2308   V2309   V2310   V2311   V2312   V2313
V2314   V2315   V2316   V2317   V2318   V2319   V2320   V2321   V2410   V2430
V2500   V2501   V2502   V2503   V2510   V2511   V2512   V2513   V2520   V2521
V2522   V2523   V2530   V2531   V2623   V2624   V2625   V2626   V2627   V2628
V2629   V2700   V2702   V2710   V2715   V2718   V2730   V2740   V2641   V2642
V2743   V2744   V2745   V2750   V2755   V2756   V2760   V2761   V2762   V2770
V2780   V2782   V2783   V2784   V2786   V2797   XX006   XX011   ZZ005   ZZ007

When the Action Code is '4' or '7', bypass this edit.

 When the Revenue Code is equal to '0001', bypass this edit.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 238
______________________________________________________________________________


 When the No-Pay Code is 'N' or the Total Charges equals the
 Non-Covered Charges on the current Revenue Line, bypass
 this edit.

 When the bill type is not '12x', '13x', '22x', '32x',
 '33x', '34x', '74x', '75x', 83x', or '85x', bypass this
 edit.

 Trailer Information: '08'

   INSTALLATION INSTRUCTIONS:     None

 **Refer to CR 00025700 for the Installation Instructions for this CR.**

   SYSTEMS DOCUMENTATION AFFECTED:

    EDITCONS                 MODIFY ERROR CODE '6912' TO INCLUDE HCPCS
                             'K0672'.

   SATELLITE SYSTEM MODIFICATIONS:       None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 239
______________________________________________________________________________

   24. 00025819   5913 NEW WAIVED TESTS

   REQUESTOR ID: CWFM2000

   IMPACT:
 (X) Host
 ( ) Satellite Part A Inpatient
 ( ) Satellite Part A Outpatient
 (X) Satellite Part B
 ( ) Hospice
 ( ) Home Health
 ( ) DMERC

   REASON FOR CHANGE:
 The CLIA regulations require a facility to be appropriately
 certified for each test performed. To ensure that Medicare and
 Medicaid only pay for laboratory tests categorized as waived
 complexity under CLIA in facilities with a CLIA certificate of
 waiver, laboratory claims are currently edited at the CLIA
 certificate level.

 The Medicare contractor shall permit the use of code 80047QW
 for claims submitted by facilities with a valid, current CLIA
 certificate of waiver with Dates of Service on or after
 01/01/2008.

 The Medicare contractor shall permit the use of code 80048QW
 for claims submitted by facilities with a valid, current CLIA
 certificate of waiver with Dates of Service on or after
 01/16/2008.

 The Medicare contractor shall permit the use of code 80051QW
 for claims submitted by facilities with a valid, current CLIA
 certificate of waiver with Dates of Service on or after
 10/30/2007.

 The Medicare contractor shall permit the use of code 80053QW
 for claims submitted by facilities with a valid, current CLIA
 certificate of waiver with Dates of Service on or after
 01/16/2008.

 Add CWF Category '69' to '80047', '80048', '80051', and '80053'.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 240
______________________________________________________________________________

   NEW BUSINESS REQUIREMENTS:

 Requirement 1
 CWF must update the current iteration for HCPCS '80047' to
 include CWF Category '69'.

 Requirement 2
 CWF must terminate the current iteration for HCPCS '80048'
 with Termination Date 01/15/2008. A new iteration must be
 created with an Effective Date of 01/16/2008 and CWF Category
 '69' added. All other information on the iteration shall be
 carried over to the new iteration.

 Requirement 3
 CWF must terminate the current iteration for HCPCS '80051'
 with Termination Date 10/29/2007. A new iteration must be
 created with an Effective Date of 10/30/2007 and CWF Category
 '69' added. All other information on the iteration shall be
 carried over to the new iteration.

 Requirement 4
 CWF must terminate the current iteration for HCPCS '80053'
 with Termination Date 01/15/2008. A new iteration must be
 created with an Effective Date of 01/16/2008 and CWF Category
 '69' added. All other information on the iteration shall be
 carried over to the new iteration.

   EVENT-RESPONSE LIST:

 Event 1.1
 Access the HCPI screen in HIMR for HCPCS code '80047'.

 Response
 Category '69' has been added.

 Event 2.1
 Access the HCPI screen in HIMR for the HCPCS code '80048'.

 Response
 The old iteration has been terminated 01/15/2008. A new iteration
 has been created with an Effective Date of 01/16/2008 and CWF
 Category '69' has been added. All other information on the
 previous iteration has been carried over.

 Event 3.1
 Access the HCPI screen in HIMR for the HCPCS code '80051'.
______________________________________________________________________________
2020 Company, LLC                                           Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 241
______________________________________________________________________________


 Response
 The old iteration has been terminated 10/29/2007. A new iteration
 has been created with an Effective Date of 10/30/2007 and CWF
 Category '69' has been added. All other information on the
 previous iteration has been carried over.

 Event 4.1
 Access the HCPI screen in HIMR for the HCPCS code '80053'.

 Response
 The old iteration has been terminated 01/15/2008. A new iteration
 has been created with an Effective Date of 01/16/2008 and CWF
 Category '69' has been added. All other information on the
 previous iteration has been carried over.

 The Entity List includes only NEW acronyms and terminology
 that is currently not in use in CWF.

 Entity List: N/A

 Areas Affected by the Problem.
   1. HCPCS table

 Solution Criteria: N/A

   EDITS AFFECTED:   None

   INSTALLATION INSTRUCTIONS:     None

   SYSTEMS DOCUMENTATION AFFECTED:       None

   SATELLITE SYSTEM MODIFICATIONS:       None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 242
______________________________________________________________________________

  25. 00025831   5977 TYPE OF SERVICE (TOS) CORRECTIONS

  REQUESTOR ID: CWFM2000

  IMPACT:
(X) Host
( ) Satellite Part A Inpatient
( ) Satellite Part A Outpatient
( ) Satellite Part B
( ) Hospice
( ) Home Health
( ) DMERC

  REASON FOR CHANGE:
Type of Service (TOS) is an indicator that the carrier places
on the claim form, mainly for data purposes. However, in some
instances it affects payment. All HCPCS codes have a corresponding
TOS indicator. This CR corrects some TOS indicators that were
not included in the 2008 annual TOS update in CR 5838.

  NEW BUSINESS REQUIREMENTS:     Under development

  EVENT-RESPONSE LIST:     Under development

  EDITS AFFECTED:   Under development

  INSTALLATION INSTRUCTIONS:     Under development

  SYSTEMS DOCUMENTATION AFFECTED:     Under development

  SATELLITE SYSTEM MODIFICATIONS:     Under development




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 243
______________________________________________________________________________

   26. 00025838   5980 APRIL UPDATES TO THE 2008 MPFSBD

   REQUESTOR ID: CWFM2000

   IMPACT:
 (X) Host
 ( ) Satellite Part A Inpatient
 (X) Satellite Part A Outpatient
 (X) Satellite Part B
 ( ) Hospice
 ( ) Home Health
 ( ) DMERC

   REASON FOR CHANGE:
 This change request amends the payment files that were issued to
 contractors based upon the 2008 Medicare Physician Fee Schedule
 Final Rule and includes new/revised codes for the Physician
 Quality Reporting Initiative.

 CMS will send CWF two files to facilitate duplicate billing
 edits: 1) Purchased Diagnostic and 2) Duplicate Radiology
 Editing. CWF shall install these files into their systems.
 CWF will be notified via email when these files have been
 sent to them.

 Effective 04/01/2008, the following HCPCS will be added
 with Type of Service '1' and the descriptors below:

 0525F- Initial visit for episode
 0526F- Subs visit for episode
 1130F- Bk pain + fxn assessed
 1134F- Epsd bk pain for =< 6 wks
 1135F- Epsd bk pain for > 6 wks
 1136F- Epsd bk pain for <= 12 wks
 1137F- Episd bk pain for > 12 wks
 2040F- Bk pn xm on init visit date
 2044F- Doc mntl tst b/4 bk trxmnt
 3330F- Imaging study ordered (bkp)
 3331F- Bk imaging tst not ordered
 3340F- Mammo assess inc xray docd
 3341F- Mammo assess negative docd
 3342F- Mammo assess bengn docd
 3343F- Mammo probably bengn docd
 3344F- Mammo assess susp docd
 3345F- Mammo assess hghlymalig doc
 3350F- Mamo bx proven malig docd
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 244
______________________________________________________________________________

 4240F-   Instr xrcz 4bk pn>12 wks
 4242F-   Sprvsd xrcz bk pn>12 wks
 4245F-   Pt instr nrml lifest
 4284F-   Pt instr-no bd rest>=4 days
 4250F-   Wrmng 4 surg- normothermia
 5060F-   Fndngs mammo 2pt w/in 3 days
 5062F-   Doc f2fmammo fndng in 3 days
 6040F-   Appro rad ds dvcs techs docd
 6045f-   Radxps in end rprt4fluro pxd
 7020F-   Mammo assess cat in dbase
 7025F-   Pt infosys alarm 4 nxt mammo

 Revisions to descriptors will be made to the following HCPCS:

 (505F,   0507F,   0509F, 0513F,   0514F,   0516F,   0517F,   0518F,   0519F,
 0521F,   1040F,   1100F, 1101F,   1119F,   1121F,   1123F,   1124F,   1125F,
 1126F,   1128F,   2030F, 2031F,   2035F,   3073F,   3095F,   3110F,   3215F,
 3216F,   3218F,   3220F, 3260F,   3265F,   3266F,   3268F,   3271F,   3272F,
 3273F,   3288F,   3292F, 3300F,   3301F,   3302F,   3303F,   3304F,   3305F,
 3306F,   3307F,   3308F, 3309F,   3310F,   3311F,   3312F,   3317F,   3318F,
 3320F,   4005F,   4040F, 4056F,   4062F,   4067F,   4070F,   4084F,   4100F,
 4120F,   4124F,   4130F, 4152F,   4164F,   4167F,   4168F,   4171F,   4172F,
 4174F,   4176F,   4177F, 4178F,   4180F,   4181F,   4182F,   4185F,   4186F,
 4187F,   4189F,   6030F.)

   NEW BUSINESS REQUIREMENTS:

 Requirement 1
 CWF will update the internal copybook (CABCDIAG) that will
 store the CPT/HCPCS codes that are applicable to the
 duplicate editing.

 The initial values have been provided by CMS and are
 updated as a replacement file quarterly by CMS.

 The following is an example of the layout of the copybook
 and the HCPCS/CPT values may vary.

     01    LAB-HCPC-CPT-TABLE.
           05 LAB-HCPC-CPT-VALUES.
               10 FILLER    PIC X (05)   VALUE 'G0030'.
               10 FILLER    PIC X (05)   VALUE 'G0031'.
               10 FILLER    PIC X (05)   VALUE 'G0032'.
               10 FILLER    PIC X (05)   VALUE '99185'.
               10 FILLER    PIC X (05)   VALUE '99186'.
               10 FILLER    PIC X (05)   VALUE '99195'.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 245
______________________________________________________________________________

           05   LAB-HCPC-CPT-LOOKUP   REDEFINES
                LAB-HCPC-CPT-VALUES OCCURS 000001179 TIMES
                ASCENDING KEY IS LAB-HCPC-CPT-LOOKUP
                INDEXED BY CPT-INDEX.
                10 LAB-HCPC-CPT-CODE

 Requirement 2
 CWF will update the internal copybook (CABCRADO) that will
 store the Radiology HCPCS codes that are applicable to the
 duplicate editing.

 The initial values have been provided by CMS and are
 updated as a replacement file quarterly by CMS.

 The following is an example of the layout of the copybook
 and the HCPCS values may vary.

    01   RADO-HCPC-CPT-TABLE.
         05 RADO-HCPC-CPT-VALUES.
             10 FILLER PIC X(05) VALUE 'G0106'.
             10 FILLER PIC X(05) VALUE 'G0120'.
             10 FILLER PIC X(05) VALUE 'G0130'.
             10 FILLER PIC X(05) VALUE '93980'.
             10 FILLER PIC X(05) VALUE '93981'.
         05 RADO-HCPC-CPT-LOOKUP REDEFINES
             RADO-HCPC-CPT-VALUES OCCURS 000000673 TIMES
             ASCENDING KEY IS RADO-HCPC-CPT-LOOKUP
             INDEXED BY RADO-INDEX.
             10 RADO-HCPC-CPT-CODE    PIC X(05).

 Requirement 3
 CWF will add the following HCPCS with an Effective Date
 of 04/01/2008 with a '1' Type of Service and the
 descriptors below:

 0525F- Initial visit for episode
 0526F- Subs visit for episode
 1130F- Bk pain + fxn assessed
 1134F- Epsd bk pain for =< 6 wks
 1135F- Epsd bk pain for > 6 wks
 1136F- Epsd bk pain for <= 12 wks
 1137F- Epsd bk pain for > 12 wks
 2040F- Bk pn xm on init visit date
 2044F- Doc mntl tst b/4 bk trxmnt
 3330F- Imaging study ordered (bkp)
 3331F- Bk imaging tst not ordered
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 246
______________________________________________________________________________

3340F-   Mammo assess inc xray docd
3341F-   Mammo assess negative docd
3342F-   Mammo assess bengn docd
3343F-   Mammo probably bengn docd
3344F-   Mammo assess susp docd
3345F-   Mammo assess hghlymalig doc
3350F-   Mammo bx proven malig docd
4240F-   Instr xrcz 4bk pn>12 wks
4242F-   Sprvsd xrcz bk pn>12 wks
4245F-   Pt instr nrml lifest
4248F-   Pt instr-no bd rest>=4 days
4250F-   Wrmng 4 surg- normothermia
5060F-   Fndngs mammo 2pt w/in 3 days
5062F-   Doc f2fmammo fndng in 3 days
6040F-   Appro rad ds dvcs techs docd
6045f-   Radxps in end rprt4fluro pxd
7020F-   Mammo assess cat in dbase
7025F-   Pt infosys alarm 4 nxt mammo

Requirement 4
CWF will make revisions to the long and/or short descriptors
for the HCPCS listed below as follows:

 0505F- Hemodialysis plan docd
 0507F- Periton dialysis plan docd
 0509F- Urine incon plan docd
 0513F- Elev bp plan of care docd
 0514F- Care plan hgb docd esa pt
 0516F- Anemia plan of care docd
 0517F- Glaucoma plan of care docd
 0518F- Fall plan of care docd
 0519F- Pland chemo docd b/4 txmnt
 0521F- Plan of care 4 pain docd
 1040F- DSM-IV info MDD docd
 1100F- Ptfalls assess-docd ge2+/yr
 1101F- Pt falls assess-docd le1/yr
 1119F- Init eval for condition
 1121F- Subs eval for condition
 1123F- ACP discuss/dscn mkr docd
 1124F- ACP discuss-no dscnmkr docd
 1125F- Amnt pain noted pain prsnt
 1126F- Amnt pain noted none prsnt
 1128F- Subs episode for condition
 2030F- H2O stat docd normal
 2031F- H2O stat docd dehydrated
 2035F- Tymp memb motion examd
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 247
______________________________________________________________________________

 3073F- Pre-surg eye measures docd
 3095F- Central dexa results docd
 3110F- Pres/absn hmrhg/lesion docd
 3215F- Pt immunity to hep A docd
 3216F- Pt immunity to hep B docd
 3218F- RNA tstng hep C docd-done
 3220F- Hec C quant rna tstng docd
 3260F- Pt cat/pn cat/hist grd docd
 3265F- RNA tstng HepC vir ord/docd
 3266F- HepC gn tstng docd b/4txmnt
 3268F- PSA/T/GLSC docd b/4 txmnt
 3271F- Low risk prostate cancer
 3272F- Med risk prostate cancer
 3273F- High risk prostate cancer
 3288F- Fall risk assessment docd
 3292F- HIV tstng asked/docd/revwd
 3300F- AJCC stage docd b/4 thxpy
 3301F- Cancer stage docd metast
 3302F- AJCC stage 0 docd
 3303F- AJCC stage IA docd
 3304F- AJCC stage IB docd
 3305F- AJCC stage IC docd
 3306F- AJCC stage IIA docd
 3307F- AJCC stage IIB docd
 3308F- AJCC stage IIC docd
 3309F- AJCC stage IIIA docd
 3310F- AJCC stage IIIB docd
 3311F- AJCC stage IIIC docd
 3312F- Ajcc stage iv docd
 3317F- Path rpt malig cancer docd
 3318F- Path rpt malig cancer docd
 3319F- X-ray/CT/Ulstsnd et al ordd
 3320F- No Xray/CT/ et al ordd
 4005F- Pharm thx for op rxd
 4040F- Pneumoc vac/admin/rcvd
 4056F- Approp oral rehyd recommd
 4062F- Pt referral psych docd
 4067F- Pt referral for ECT docd
 4070F- Dvt prophylx recvd day 2
 4084F- Aspirin recvd w/in 24 hrs
 4100F- Biphos thxpy vein ord/recvd
 4120F- Antibiot rxd/given
 4124F- Antibiot not rxd/given
 4130F- Topical prep rx AOE
 4152F- Docd pegintf/rib thxy consd
 4164F- Adjv hrmnl thxpy Rxd
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 248
______________________________________________________________________________

 4167F-   Hd Bed tilted 1st day vent
 4168F-   Pt care ICU & vent w/in 24 hrs
 4171F-   Pt rcvng ESA thxpy
 4172F-   Pt not rcvng ESA thxpy
 4174F-   Couns potent Glauc impct
 4176F-   Talk re UV light pt/crgvr
 4177F-   Talk pt/crgvr re AREDS prev
 4178F-   AntiD glbln rcvd w/in 26 wks
 4180F-   Adjv thxpyRxd/rcvd Stg3 A-C
 4181F-   Conformal radn thxpy rcvd
 4182F-   No conformal radn thxpy
 4185F-   Continuous PPI or H2RA rcvd
 4186F-   No Cont PPI or H2RA rcvd
 4187F-   Anti rheum Drugthxpy Rxd/gvn
 4189F-   Approp digoxin tstng done
 6030F-   Max steril barriers follwd

   EVENT-RESPONSE LIST:

 Event 1.1
 Submit an HUBC claim that contains one of the new HCPCS codes
 on the LAB DIAGNOSTIC File . Posted to history is an HUBC
 record with the same HCPCS code, same Date of Service and a
 different Carrier Number.

 Response
 The claim is rejected, error code '7282' is set.

 Event 2.1
 Submit an HUBC claim that contains one of the new HCPCS
 codes on the RADIOLOGY DIAGNOSTIC File. The Date of Service
 on the incoming claim is equal to, or within the Admission
 or Discharge Date of a covered '11x' HUIP record posted to
 history.

 Response
 The claim is rejected, error code '729D' is set.

 Event 2.2
 Submit an HUBC claim that contains one of the new HCPCS
 codes on the RADIOLOGY DIAGNOSTIC File. The Date of Service
 on the incoming claim is equal to, or within the Admission
 or Discharge Date of a covered LTCH, IPF, or IRF stay posted
 to history. The Dates of Service on the Part B record are
 outside the Occurrence Span Code '74' from and thru date
 plus one day.
______________________________________________________________________________
2020 Company, LLC                                           Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 249
______________________________________________________________________________


 Response
 The claim is rejected, error code '729J' is set.

 Event 3.1
 Access the HCPI file in HIMR.

 Response
 The HCPCS codes listed below are found with the correct
 descriptors, effective 04/01/2008 with a Type of Service '1':

 0525F-   Initial visit for episode
 0526F-   Subs visit for episode
 1130F-   Bk pain + fxn assessed
 1134F-   Epsd bk pain for =< 6 wks
 1135F-   Epsd bk pain for > 6 wks
 1136F-   Epsd bk pain for <= 12 wks
 1137F-   Epsd bk pain for > 12 wks
 2040F-   Bk pn xm on init visit date
 2044F-   Doc mntl tst b/4 bk trxmnt
 3330F-   Imaging study ordered (bkp)
 3331F-   Bk imaging tst not ordered
 3340F-   Mammo assess inc xray docd
 3341F-   Mammo assess negative docd
 3342F-   Mammo assess bengn docd
 3343F-   Mammo probably bengn docd
 3344F-   Mammo assess susp docd
 3345F-   Mammo assess hghlymalig doc
 3350F-   Mammo bx proven malig docd
 4240F-   Instr xrcz 4bk pn>12 wks
 4242F-   Sprvsd xrcz bk pn>12 wks
 4245F-   Pt instr nrml lifest
 4248F-   Pt instr-no bd rest>=4 days
 4250F-   Wrmng 4 surg- normothermia
 5060F-   Fndngs mammo 2pt w/in 3 days
 5062F-   Doc f2fmammo fndng in 3 days
 6040F-   Appro rad ds dvcs techs docd
 6045f-   Radxps in end rprt4fluro pxd
 7020F-   Mammo assess cat in dbase
 7025F-   Pt infosys alarm 4 nxt mammo

 Event 4.1
 Access the HCPI file in HIMR.



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 250
______________________________________________________________________________

Response
The HCPCS codes listed below are found with the appropriate
long and/or short descriptors:

 0505F- Hemodialysis plan docd
 0507F- Periton dialysis plan docd
 0509F- Urine incon plan docd
 0513F- Elev bp plan of care docd
 0514F- Care plan hgb docd esa pt
 0516F- Anemia plan of care docd
 0517F- Glaucoma plan of care docd
 0518F- Fall plan of care docd
 0519F- Pland chemo docd b/4 txmnt
 0521F- Plan of care 4 pain docd
 1040F- DSM-IV info MDD docd
 1100F- Ptfalls assess-docd ge2+/yr
 1101F- Pt falls assess-docd le1/yr
 1119F- Init eval for condition
 1121F- Subs eval for condition
 1123F- ACP discuss/dscn mkr docd
 1124F- ACP discuss-no dscnmkr docd
 1125F- Amnt pain noted pain prsnt
 1126F- Amnt pain noted none prsnt
 1128F- Subs episode for condition
 2030F- H2O stat docd normal
 2031F- H2O stat docd dehydrated
 2035F- Tymp memb motion examd
 3073F- Pre-surg eye measures docd
 3095F- Central dexa results docd
 3110F- Pres/absn hmrhg/lesion docd
 3215F- Pt immunity to hep A docd
 3216F- Pt immunity to hep B docd
 3218F- RNA tstng hep C docd-done
 3220F- Hec C quant rna tstng docd
 3260F- Pt cat/pn cat/hist grd docd
 3265F- RNA tstng HepC vir ord/docd
 3266F- HepC gn tstng docd b/4txmnt
 3268F- PSA/T/GLSC docd b/4 txmnt
 3271F- Low risk prostate cancer
 3272F- Med risk prostate cancer
 3273F- High risk prostate cancer
 3288F- Fall risk assessment docd
 3292F- HIV tstng asked/docd/revwd
 3300F- AJCC stage docd b/4 thxpy
 3301F- Cancer stage docd metast
 3302F- AJCC stage 0 docd
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 251
______________________________________________________________________________

3303F-   AJCC stage IA docd
3304F-   AJCC stage IB docd
3305F-   AJCC stage IC docd
3306F-   AJCC stage IIA docd
3307F-   AJCC stage IIB docd
3308F-   AJCC stage IIC docd
3309F-   AJCC stage IIIA docd
3310F-   AJCC stage IIIB docd
3311F-   AJCC stage IIIC docd
3312F-   Ajcc stage iv docd
3317F-   Path rpt malig cancer docd
3318F-   Path rpt malig cancer docd
3319F-   X-ray/CT/Ulstsnd et al ordd
3320F-   No Xray/CT/ et al ordd
4005F-   Pharm thx for op rxd
4040F-   Pneumoc vac/admin/rcvd
4056F-   Approp oral rehyd recommd
4062F-   Pt referral psych docd
4067F-   Pt referral for ECT docd
4070F-   Dvt prophylx recvd day 2
4084F-   Aspirin recvd w/in 24 hrs
4100F-   Biphos thxpy vein ord/recvd
4120F-   Antibiot rxd/given
4124F-   Antibiot not rxd/given
4130F-   Topical prep rx AOE
4152F-   Docd pegintf/rib thxy consd
4164F-   Adjv hrmnl thxpy Rxd
4167F-   Hd Bed tilted 1st day vent
4168F-   Pt care ICU & vent w/in 24 hrs
4171F-   Pt rcvng ESA thxpy
4172F-   Pt not rcvng ESA thxpy
4174F-   Couns potent Glauc impct
4176F-   Talk re UV light pt/crgvr
4177F-   Talk pt/crgvr re AREDS prev
4178F-   AntiD glbln rcvd w/in 26 wks
4180F-   Adjv thxpyRxd/rcvd Stg3 A-C
4181F-   Conformal radn thxpy rcvd
4182F-   No conformal radn thxpy
4185F-   Continuous PPI or H2RA rcvd
4186F-   No Cont PPI or H2RA rcvd
4187F-   Anti rheum Drugthxpy Rxd/gvn
4189F-   Approp digoxin tstng done
6030F-   Max sterile barriers follwd



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 252
______________________________________________________________________________

 The Entity List includes only NEW acronyms and terminology
 that is currently not in use in CWF.

 Entity List: N/A

 Areas Affected by the Problem.
   1. HCPCS Table

 Solution Criteria: N/A

   EDITS AFFECTED:   None

   INSTALLATION INSTRUCTIONS:     None

   SYSTEMS DOCUMENTATION AFFECTED:       None

   SATELLITE SYSTEM MODIFICATIONS:       None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 253
______________________________________________________________________________

   27. 00025841   5981 NEW HCPCS CODES FOR APRIL 2008 UPDATE

   REQUESTOR ID: CWFM2000

   IMPACT:
 (X) Host
 (X) Satellite Part A Inpatient
 (X) Satellite Part A Outpatient
 ( ) Satellite Part B
 ( ) Hospice
 ( ) Home Health
 (X) DMERC

   REASON FOR CHANGE:
 The HCPCS code set is updated on a quarterly basis. This CR
 describes the process for updating specific HCPCS codes.

 Effective for claims with Dates of Service on or after 04/01/2008,
 the following HCPCS codes will no longer be payable for
 Medicare: 'J7602', 'J7603', 'J1751', and 'J1752'.

 Effective for claims with Dates of Service on or after 04/01/2008,
 the following HCPCS codes will be payable for Medicare with
 a Types of Service '1' and 'P': 'J7611', 'J7612', 'J7613', 'J7614',
 'Q4096', 'Q4097', and 'Q4098'.

 CWF Categories '17' and '60' shall be added to HCPCS codes 'J7611',
 'J7612', 'J7613', 'J7614', 'Q4096', 'Q4097', and 'Q4098'.

 CWF will modify consistency edit '51#G' to include 'Q4096' in the logic.

   NEW BUSINESS REQUIREMENTS:

 Requirement 1
 CWF must terminate the following HCPCS codes with the
 termination date of 03/31/2008:
 J7602
 J7603
 J1751
 J1752

 Requirement 2
 CWF shall create a new iteration for the following HCPCS
 using the same descriptors, types of service '1' and 'P', and
 CWF categories '17' and '60' that are currently on file with
 an effective date of 04/01/2008:
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 254
______________________________________________________________________________


 J7611
 J7612
 J7613
 J7614

 Requirement 3
 CWF must add the following HCPCS and descriptors with Types of
 Service '1' and 'P', CWF Categories '17' and '60', effective
 04/01/2008:

 Q4096-   Injection, Von Willebrand Factor Complex, Human,
          Ristocetin cofactor (not otherwise specified) per I.U.
 Q4097-   Injection, Immune Globulin (Privigen), intravenous,
          non-lyophilized, 500 mg
 Q4098-   Injection, Iron Dextran, 50 mg

 Requirement 4
 CWF will modify consistency edit '51#G' to include 'Q4096'
 in the logic.

   EVENT-RESPONSE LIST:

 Event 1.1
 Access the HCPI file in HIMR for HCPCS codes 'J7602', 'J7603',
 'J1751', and 'J1752'.

 Response
 The iteration has been terminated effective 03/31/2008.

 Event 2.1
 Access the HCPI file in HIMR for HCPCS codes 'J7611', 'J7612',
 'J7613', and 'J7614'.

 Response
 A new iteration has been created for each using an effective date
 of 04/01/2008 using the same descriptor, Type of Service '1' and
 'P' and CWF Categories '17' and '60' as was on the previous
 iteration.

 Event 3.1
 Access the HCPI file in HIMR for new HCPCS codes 'Q4096',
 'Q4097', and 'Q4098'.



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 255
______________________________________________________________________________

 Response
 The codes are listed with an effective date of 04/01/2008, Types
 of Service '1' and 'P', CWF Categories '17' and '60' and the
 descriptors as follows:

 Q4096-   Injection, Von Willebrand Factor Complex, Human,
          Ristocetin cofactor (not otherwise specified) per I.U.
 Q4097-   Injection, Immune Globulin (Privigen), intravenous,
          non-lyophilized, 500 mg
 Q4098-   Injection, Iron Dextran, 50 mg

 Event 4.1
 Submit an HUIP record using HCPC code 'Q4096' with a principal
 or other diagnosis of Hemophilia, '286.0', '286.1', '286.2',
 '286.3', '286.4', '286.5', or '286.7.

 Response
 The record is accepted, edit '51#G' is not set.

 The Entity List includes only NEW acronyms and terminology
 that is currently not in use in CWF.

 Entity List: N/A

 Areas Affected by the Problem.
   1. HCPCS table
   2. Consistency Module (HUIPCED)

 Solution Criteria: N/A

   EDITS AFFECTED:

 a. Error Code:      51#G   ( )New (X)Modified ( )Deleted
 Disposition: ER

 Type of Record:     Hospital, SNF

 Error Message:
 Blood clotting factor HCPCS codes 'J7187', 'J7188', 'J7190',
 'J7191', 'J7192', 'J7193', 'J7194', 'J7195', 'J7196', 'J7198',
 'J7199', 'Q0160', 'Q0161', 'Q0187', and 'Q2022' can only be
 billed with a principal or other diagnosis of hemophilia ('286.0',
 '286.1', '286.2', '286.3', '286.4', '286.5', or '286.7').



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 256
______________________________________________________________________________

Set Condition for edit '51#G':
When a Blood clotting factor HCPCS code ('J7187', 'J7188',
'J7189', 'J7190', 'J7191', 'J7192', 'J7193', 'J7194', 'J7195',
'J7196', 'J7198', 'J7199', 'Q0160', 'Q0161', 'Q0187', or
'Q2022') is not billed with a principal or other diagnosis of
Hemophilia ('286.0', '286.1', '286.2', '286.3', '286.4',
'286.5', or '286.7') set the '51#G' error code.

Trailer Information: 08

  INSTALLATION INSTRUCTIONS:   None

  SYSTEMS DOCUMENTATION AFFECTED:

    EDITCONS              MODIFY CONSISTENCY EDIT '51#G' TO INCLUDE
                          HCPCS CODE 'Q4096'

  SATELLITE SYSTEM MODIFICATIONS:     None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 257
______________________________________________________________________________

C.        ANALYSIS CHANGE REQUESTS

     1.     00024814     5030-ANALYSIS ONLY PROCESSING DX CDS FOR DME MACS

     REQUESTOR ID: CWFM2000

   IMPACT:
 (X) Host
 ( ) Satellite Part A Inpatient
 ( ) Satellite Part A Outpatient
 ( ) Satellite Part B
 ( ) Hospice
 ( ) Home Health
 (X) DMERC

     REASON FOR CHANGE:

 *** Note: This is an ANALYSIS Only effort and does not contain
           any software updates. ***

 Date Prepared:           12/14/07

 Release:        R2008200

 CWF CR #:        24814

 CMS CR #:        5030

 Early Involvement Call Needed?         NO

 Title:   ANALYSIS ONLY PROCESSING DX CDS FOR DME MACS
 Business Analyst:   Janice Maxwell

 CMS Contact:           Kathy Woyton

 Programmer:           Denny Wingert

 CR Description:
 The purpose of this instruction is to implement requirements
 in the VMS so all diagnosis codes reported on a claim are
 processed up to the maximum allowed by the ASC X12N 837P
 Transaction, Version 4010A1 claim format. Typically paper
 claims only have four diagnoses. However, if more than four
 diagnosis codes are reported on a paper claim, VMS shall
 capture up to eight diagnosis codes.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 258
______________________________________________________________________________

 This change request will also implement requirements to pass
 this information to the Common Working File (CWF) for
 processing and the National Claim History (NCH) for storage.
 This CR is being implemented in multiple phases. This is the
 first phase which includes only the analysis and design.

 Type of Claim/Transaction Affected:    HUDC

 Software Functions Affected:

 Edits Affected:     N/A

 Trailers/Responses Affected:     N/A

 Auxiliary Files Affected:      N/A

 HCPCS Affected:         N/A

 IUR Affected:     N/A

 HIMR: CWF will modify the DMEH screen to display up to eight diagnosis
 codes if submitted on the header portion of the HUDC claim.

 ITF: CWF will modify the HIDC transaction of the internal testing
 facility to accept up to eight diagnosis codes if submitted on the
 header portion of the HUDC claim.

 Claims History: CWF will modify claim history to carry and store all
 eight diagnosis fields on the incoming HUDC record.

 New Process to Apply:   Beginning at a date to be determined in a future
 CWF will begin capturing and processing up to eight diagnosis codes when
 submitted on an HUDC claim.

 Analysis:
 CWF will need to make the following modifications to accept, and transmit
 up to eight diagnosis codes when submitted on an HUDC claim:

 A) Modify the DMEH header screen in HIMR to story and display all
    eight diagnosis fields.

 B) Modify the header screen on the HIDC record in ITF to include four
    additional new fields for diagnosis codes.

 C) Modify claim history to carry and store all eight diagnosis fields
    on the incoming HUDC record.
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Section VII. Detailed Description of Changes                          Page 259
______________________________________________________________________________


   NEW BUSINESS REQUIREMENTS:      None

   EVENT-RESPONSE LIST:     None

   EDITS AFFECTED:   None

   INSTALLATION INSTRUCTIONS:      None

   SYSTEMS DOCUMENTATION AFFECTED:        None

   SATELLITE SYSTEM MODIFICATIONS:        None




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 260
______________________________________________________________________________

APPENDIX A:   INSTALLATION INSTRUCTIONS

**********************************************************
*************       I M P O R T A N T       **************
**********************************************************
* THESE INSTALLATION INSTRUCTIONS SUPERCEDE ALL PREVIOUS *
* QUARTERLY RELEASE INSTALLATION INSTRUCTIONS.           *
**********************************************************

The R2008200 Release Installation Instructions have been
Organized into HOST Instructions and Satellite Instructions
With four sections each to assist in the installation process.
Each section contains instructions that should occur during
Each stage of the installation process.

The sections are Pre-Pre-Installation, Pre-Installation,
Installation and Post Installation.




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 261
______________________________________________________________________________

********************************************************
********************************************************
*                HOST INSTRUCTIONS:                    *
********************************************************
********************************************************

********************************************************
*   I.          PRE-PRE-INSTALLATION:             HOST *
********************************************************

I.1. INSTRUCTIONS TO HOLD XREF TRANSACTIONS FOR R2008200 RELEASE

CMS CR 00025718 - 5812 INCLUDE NPI FOR MBD/NGD FROM CWF ON HOSP &
HH, will require all the XREF transactions to be held three
days prior to the implementation of R2008200 release.

In order to ensure that no XREF merges are pending for the
implementation weekend of R2008200 release, all Host sites
must activate the 'BYPASS XREF PROCESSING PARAMETER' beginning
April 02, 2008 as follows:

(1). Change the HXDLOPT parameter in the CABHCFA step of the
     CABMDC06 job/CAB$BMP1 Procedure to 'N'. This parameter
     position should presently be set to 'X' for Production.
     With the PARM change in place for the April 02, 2008
     CABMDC06 cycle, no new HXDL transactions will be processed.
     This will stop the creation of HBBM records.

(2). Delete all prior generations of the HOLDHXDL datasets input
     to CABMDC06 job CAB$BMP1 proc CABHCFA step. Modify CABMDC06
     to override CAB$BMP1 proc CABHCFA step DD HOLDHXDL as a DUMMY
     dataset. This will ensure that only those XREF HXDL transaction
     received during the period of April 02, 2008 through
     April 04, 2008 are stored on the HOLDHXDL GDG's.

Example: CABHCFA.HOLDHXDL DD DUMMY

(3). After R2008200 release is loaded to production, CWF will
     distribute the instructions for re-introducing the HXDL
     transactions to the system. The re-activation of XREF
     processing is expected to occur with the first cycle for
     the week beginning April 07, 2008.


********************************************************

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 262
______________________________________________________________________________


I.2. INSTRUCTIONS TO DROP OSA TRANSACTIONS FOR R2008200 RELEASE

CMS CR 00025718 - 5812 INCLUDE NPI FOR MBD/NGD FROM CWF ON HOSP &
HH, requires the OSA transactions to be dropped four cycles
prior to the implementation of R2008200 release.

CWFM will drop OSA claims as of April 02, 2008. This means that
the CABBHXMT run on April 01, 2008 is the last CABBHXMT job that
will be sent OSA, with the exception of the unsolicited
informational responses which will continue to be sent OSA, until
the release is installed and in production on April 07, 2008.

OSA claims received on April 02, 2008 until release
installation will be dropped and will need to be recycled after
the release is in production. Regular OSA processing will
resume on date April 07, 2008.

Add the PARM to CABBHMXT job to suppress OSA processing of all
record types starting with the April 02, 2008 CABBHXMT Job.
This needs to be done to ensure that OSA transactions are not
sent into the R2008200 release software in the old format.

//     SKIP='08093000000,08095999999,A,X,X,X,X,X,X,XXX'
//* A=ALL, B=PARTB/DME, C=CMN, E=ESRD, I=HUIP, O=HUOP/HUHH/HUHC

Although claims are being dropped for OSA, Hosts are required to
continue to execute their CABBHXMT/CABBHRCV to load and create
the unsolicited informational responses.

All the Hosts will have to make sure that the CABOS* files are
empty prior to running their first cycle with R2008200 release
software. This has to be done to clear out any old claims that are
sitting in CABOS* files, failure to do this may cause some
erroneous results.


********************************************************




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 263
______________________________________________________________________________


I.3. SPECIAL INSTRUCTIONS

None at this time.


********************************************************




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 264
______________________________________________________________________________


********************************************************
* II.            PRE-INSTALLATION:                HOST *
********************************************************

II.1. Hosts should clear out all previous cycle files prior
      to running the first cycle of the R2008200 Release.


********************************************************




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 265
______________________________________________________________________________


********************************************************
* III.              INSTALLATION:                 HOST *
********************************************************

* Weekend of April 5, 2008

III.1. Install the R2008200 Release Software.

        All CRs


********************************************************




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 266
______________________________________________________________________________


III.2.1. HCPCS Table Installation Instructions

    CR 00025786

  A. Conversion
     This section indicates the type of file affected:
     (Note - Mark ALL that apply with an "X")

    __X_     Production File Conversion
    __X_     Test File Conversion

      This section identifies who converts the file:
      (Note - Mark ALL that apply with an "X")

      __X_    Beta File Conversion
      __X_    Host File Conversion
      ____    Satellite File Conversion

  B. Timing Considerations
     Load the HCPCS Table before the first cycle using the
     Release software.

  C. Requirement
     Update the HCPCS Table.

  D. Important Notes
     None.

  E. Installation Steps
     Load the HCPCS Table using the INITHCPC utility.


********************************************************




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 267
______________________________________________________________________________


III.2.2. Carrier Table Installation Instructions

None at this time.


********************************************************




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 268
______________________________________________________________________________


III.3. CICS Table Changes (HOST)

None at this time.


********************************************************




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 269
______________________________________________________________________________


III.4.    Host One Timer Jobs

        CR 00025640
    and CR 00025718

III.4.1. CR 00025640

***************
U T L J 8 2 A 0
***************

A. Conversion
   This section notes the type of file that is being created

   _X__      Production File Conversion
   _X__      Test File Conversion

   This section notes who converts the file:

   _X__     Beta File Conversion
   _X__     Host File Conversion
   ____     Satellite File Conversion

B. Timing Considerations
   Jobs UTLJ82A0 must be run after the installation
   of the R2008200 release software and before the first
   cycle using the R2008200 release software.

C. Requirement
   Modify the UTLJ82A0 execution JCL provided with the
   r2008200 release to meet the requirements of your
   site.

   The execution JCL can be found in the '*.R2008200.H.SW.UTILLIB',
   member UTLJ82A0.

D. Important Notes

   UTLJ82A0 must be run with files closed.

E. Installation Steps

   Jobs UTLJ82A0 is run to expand the key and file lengths
   of the VISNAUX file.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 270
______________________________________________________________________________

   1) Insure that The VISNAUX file is closed in the region.

   2) Execute the job, UTLJ82A0

     a) DELETE step Deletes all working datasets.
     b) BACKUP1 step Repros the VSAM VISNAUX file into a flat
        file.
     c) UTLS82A0 step expands VISNAUX key length from 11 to
        14 bytes and the length to 2097 bytes.
     d) DELDEF step will delete/define VSAM VISNAUX file.
     e) RELOAD1 will repro the new expanded sequential file to
        the VSAM file.
     f) All counts are displayed on Sysout.

   3) Open all files in the region.


********************************************************




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 271
______________________________________________________________________________


III.4.2. CR 00025718

***************
U T L J 8 2 B 0
***************

  A. Conversion
     This section notes the type of file that is being created

     _X__    Production File Conversion
     _X__    Test File Conversion

     This section notes who converts the file:

     _X__    Beta File Conversion
     _X__    Host File Conversion
     ____    Satellite File Conversion

  B. Timing Considerations
     Jobs UTLJ82B0 must be run after the installation
     of the R2008200 release software and before the first
     cycle using the R2008200 release software.

  C. Requirement
     Modify the UTLJ82B0 execution JCL provided with the
     R2008200 release to meet the requirements of your site.

     The execution JCL can be found in the '*.R2008200.H.SW.UTILLIB',
     member UTLJ82B0.

  D. Important Notes

     1) PARM1 in the JCL has been setup to use for TEST or
        PRODUCTION runs.

        PARM1='T' - Use when running in TEST mode
                    no HHEHAUX file updates are done
                    Steps DELDEF and RELOAD1 are not executed

        PARM1='P' - Use when running in PROD mode
                    HHEHAUX file updates are done

     2) UTLJ82B0 must be run with HHEHAUX file closed.


______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 272
______________________________________________________________________________

  E. Installation Steps
     Job UTLJ82B0 is run to initialize the new NPI field in HHEHAUX
     file and to increase the length of HHEHAUX file from 3685 to 4045
     bytes.

    1) Ensure that the HHEHAUX file is closed in the region.

    2) Execute the job, UTLJ82B0

           A) DELETE Step deletes all working datasets.
           B) BACKUP1 step repros the VSAM HHEHAUX file into a flat
              file
           C) UTLJ82B0 step to initialize the new NPI field in HHEHAUX
              file and to increase the length of HHEHAUX file from
              3685 to 4045 bytes
           D) DELDEF step will delete/define VSAM HHEHAUX file.
           E) RELOAD1 will repro the new expanded sequential file to
              the VSAM file.
           F) All counts are displayed on SYSOUT.

    3) Open HHEHAUX file in the region.


********************************************************




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 273
______________________________________________________________________________

***************
U T L J 8 2 C 0
***************

  A. Conversion
     This section notes the type of file that is being created

     ____    Production File Conversion
     _X__    Test File Conversion

     This section notes who converts the file:

     _X__    Beta File Conversion
     _X__    Host File Conversion
     ____    Satellite File Conversion

  B. Timing Considerations
     Jobs UTLJ82C0 must be run after the installation
     of the R2008200 release software and before the first
     cycle using the R2008200 release software.

  C. Requirement
     Modify the UTLJ82C0 execution JCL provided with the
     R2008200 release to meet the requirements of your
     site.

     The execution JCL can be found in the '*.R2008200.H.SW.UTILLIB',
     member UTLJ82C0.

  D. Important Notes

     1) UTLJ82C0 must be run only in test regions to convert the
        existing HCHE records in CABHICR file.

     2) PARM1 in the JCL has been setup to use for TEST or
        PRODUCTION runs.

        PARM1='T' - Use when running in TEST mode
                    no CABHICR file updates are done
                    steps DELDEF and RELOAD1 are not executed

        PARM1='P' - Use when running in PROD mode
                    CABHICR file updates are done

     2) UTLJ82C0 must be run with CABHICR file closed.

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 274
______________________________________________________________________________

  E. Installation Steps
     Job UTLJ82C0 is run to initialize the new NPI field of HCHE
     records in CABHICR file.

    1) Ensure that the CABHICR file is closed in the region.

    2) Execute the job, UTLJ82C0

           A) DELETE Step deletes all working datasets.
           B) BACKUP1 step repros the VSAM CABHICR file into a flat
              file
           C) UTLJ82C0 step to initialize the new NPI field of HCHE
              records in CABHICR file.
           D) DELDEF step will delete/define VSAM CABHICR file.
           E) RELOAD1 will repro the new expanded sequential file to
              the VSAM file.
           F) All counts are displayed on SYSOUT.

    3) Open CABHICR file in the region.


********************************************************




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 275
______________________________________________________________________________


       **************************
III.5. HOST ONE-TIMER JOB SUMMARY
       **************************

      Note: Please be sure to read this entire section before
            attempting to execute the one-timer jobs described.

      HOST ONE-TIMER JOBS

      UTLJ82A0    - Required
      UTLJ82B0    - Required
      UTLJ82C0    - Required


********************************************************




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 276
______________________________________________________________________________


********************************************************
* IV.           POST INSTALLATION:                HOST *
********************************************************

IV.1. INSTRUCTIONS TO RELEASE XREF TRANSACTIONS FOR R2008200 RELEASE

CMS CR 00025718 - 5812 INCLUDE NPI FOR MBD/NGD FROM CWF ON HOSP
& HH, required all the XREF transactions to be held three
days prior to the implementation of R2008200 release.

In order to ensure that all pending XREF merges are processed
after the implementation weekend of R2008200 release, all Host
sites must remove the 'BYPASS XREF PROCESSING PARAMETER'
beginning April 07, 2008 as follows:

(1). Change the HXDLOPT parameter in the CABHCFA Step of the
     CABMDC06 Job/CAB$BMP1 Procedure back to 'X'. This parameter
     position should presently be set to 'N' for R2008200 Release
     Implementation. With the PARM change in place for the
     April 07, 2008 CABMDC06 cycle, HXDL transactions will be
     re-introduced for processing. HBBM and HBBR transactions will
     be generated with the HICC online transaction and will be
     processed with the first R2008200 Release cycle of the week
     beginning April 07, 2008.

(2). Modify CABMDC06 Job/CAB$BMP1 Procedure/CABHCFA Step DD
     HOLDHXDL to take in all the held HxDL datasets for the
     period of April 02, 2008 through April 04, 2008.

    Important Note: There must be 3 backup HOLDHXDL generations
    of the HxDL transactions created during the hold, and one
    for the current day.

    Example: CABHCFA.HOLDHXDL DD DSN=CWF.HOST.HOLDHXDL,DISP=SHR


********************************************************




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 277
______________________________________________________________________________


********************************************************
********************************************************
********************************************************
*             Satellite INSTRUCTIONS:                  *
********************************************************
********************************************************

********************************************************
*   I.          PRE-PRE-INSTALLATION:        Satellite *
********************************************************

None at this time.


********************************************************




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 278
______________________________________________________________________________


********************************************************
* II.            PRE-INSTALLATION:           Satellite *
********************************************************

None at this time.


********************************************************




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 279
______________________________________________________________________________


********************************************************
* III.              INSTALLATION:            Satellite *
********************************************************

III.1.   Install the R2008200 Release Software.

         All CRs


********************************************************




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 280
______________________________________________________________________________


III.2. Carrier Table Installation Instructions

None at this time.


********************************************************




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 281
______________________________________________________________________________


III.3. CICS Table Changes (Satellite)

None at this time.


********************************************************




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix A: Installation Instructions                                 Page 282
______________________________________________________________________________


********************************************************
* IV.           POST INSTALLATION:           Satellite *
********************************************************

None at this time.


********************************************************




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                    R2008200
Host Quarterly Release Document                                   March 4, 2008
Appendix B: CICS Table Updates                                         Page 283
______________________________________________________________________________

APPENDIX B:   CICS TABLE UPDATES

None to report




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix C: Software Release Files                                    Page 284
______________________________________________________________________________

APPENDIX C:   SOFTWARE RELEASE FILES

 SITE     TYPE OF LIBRARY   MEMBER   VV.LL DATE    TIME TOTAL
 -------- ----------------- -------- ------------------- -----
 HOST     BATCH LOADLIB     CABBACHS 01.45 20FEB08 15:06
                            CABBEMBD 01.19 08FEB08 15:43
                            CABBHRCV 01.26 20FEB08 15:06
                            CABBHXMT 01.27 20FEB08 15:06
                            CABBINPT 01.37 20FEB08 15:10
                            CABBSPCL 01.29 20FEB08 15:10
                            CAHOSTOT 01.41 20FEB08 15:10
                            CIBLCLM  01.35 20FEB08 15:06
                            CIBPHHEH 01.05 08FEB08 15:43
                            CIBPVISN 01.04 29JAN08 14:00
                            LOADXITF 01.29 20FEB08 15:11
                            UTILLOAD 01.39 20FEB08 15:11
                            UTILMOVE 01.41 08FEB08 15:44
                            UTILPTRS 01.33 20FEB08 15:11
                            UTLSAUX1 01.30 20FEB08 15:11
                            UTLSUTUT 01.14 08FEB08 15:44
                            UTLS82A0 01.00 29JAN08 14:01
                            UTLS82B0 01.00 08FEB08 15:44
                            UTLS82C0 01.00 08FEB08 15:44
                                                            19
 HOST     COPYLIB           CABCHCHE 01.01 08FEB08 15:43
                            CABCHHEH 01.01 08FEB08 15:43
                            CABCTAUX 01.01 29JAN08 13:59
                            CABCVISN 01.04 29JAN08 13:59
                            CABECOIF 01.05 09JAN08 11:18
                            CIOCPTB 01.23 20FEB08 15:05
                            HCPCSDME 01.17 26FEB08 10:43
                            HUVISNWA 01.04 29JAN08 13:59
                                                             8
 HOST     IDCMCARD          HHEHAUX 01.01 15FEB08 11:04
                            VISNAUX 01.03 05FEB08 10:48
                                                             2
 HOST     ONLINE LOAD/COPY HHRMBN1 01.05 29JAN08 13:59
                            HHRMBN3 01.06 29JAN08 13:59
                            HHRMHDR 01.06 29JAN08 13:59
                            HHRMMEN 01.06 29JAN08 13:59
                            HHRMMP2 01.09 29JAN08 13:59
                            HHRMTLR 01.06 29JAN08 14:00
                            HIBCM02 01.13 20FEB08 15:05
                            HICRMOP 01.19 08FEB08 15:43
                            HIDCM02 01.13 20FEB08 15:05
                                                             9
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix C: Software Release Files                                    Page 285
______________________________________________________________________________

 SITE     TYPE OF LIBRARY   MEMBER   VV.LL DATE    TIME TOTAL
 -------- ----------------- -------- ------------------- -----
 HOST     ONLINE LOADLIB    CIOPCLM 01.36 20FEB08 15:11
                            CIOPHHEH 01.06 08FEB08 15:45
                            CIOPVISN 01.06 20FEB08 15:12
                            ELGACOP 01.37 08FEB08 15:45
                            ELGBCOP 01.31 08FEB08 15:45
                            ELGHCOP 01.32 08FEB08 15:45
                            HABBAUDT 01.11 20FEB08 15:12
                            HABBHBBM 01.05 29JAN08 14:03
                            HABBHCHE 01.06 08FEB08 15:46
                            HABBHHMO 01.14 28FEB08 15:11
                            HABBHIBC 01.09 20FEB08 15:12
                            HABBHIDL 01.05 29JAN08 14:03
                            HABBHIHO 01.05 08FEB08 15:46
                            HABBHIID 01.05 29JAN08 14:04
                            HABBHNDM 01.11 20FEB08 15:12
                            HABWHHEH 01.05 08FEB08 15:47
                            HABWPCLM 01.08 20FEB08 15:12
                            HABWPTBH 01.08 20FEB08 15:12
                            HABWVISN 01.05 29JAN08 14:04
                            HHBPUSPL 01.46 08FEB08 15:47
                            HHEHUSPL 01.54 20FEB08 15:12
                            HIABCCR 01.73 20FEB08 15:13
                            HIABCCR2 01.89 20FEB08 15:13
                            HIABNSOL 01.49 20FEB08 15:14
                            HIABUNSL 01.33 20FEB08 15:14
                            HIBCCIP 01.40 20FEB08 15:14
                            HIBCCOP 01.40 20FEB08 15:15
                            HICOCPR 01.34 20FEB08 15:15
                            HICRCBC 01.35 20FEB08 15:15
                            HICRCDC 01.35 20FEB08 15:15
                            HICRC00 01.42 08FEB08 15:47
                            HIDCCIP 01.38 20FEB08 15:15
                            HIDCCOP 01.39 20FEB08 15:15
                            HIIPCIP 01.39 22JAN08 10:46
                            HIIPCOP 01.36 22JAN08 10:46
                            HIMCMSPU 01.10 20FEB08 15:15
                            HIOPCIP 01.40 22JAN08 10:47
                            HIOPCOP 01.39 22JAN08 10:47
                            HIQACOP 01.43 08FEB08 15:47
                            HIQHCOP 01.33 08FEB08 15:48
                            HMRCALIN 01.12 29JAN08 14:04
                            HMRCBENA 01.30 29JAN08 14:04
                            HMRCBENB 01.29 29JAN08 14:04
                            HMRCBOD 01.23 29JAN08 14:04
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix C: Software Release Files                                    Page 286
______________________________________________________________________________

 SITE     TYPE OF LIBRARY   MEMBER   VV.LL DATE    TIME TOTAL
 -------- ----------------- -------- ------------------- -----
                            HMRCBOI 01.23 29JAN08 14:05
                            HMRCCAPS 01.06 29JAN08 14:05
                            HMRCCEPP 01.21 29JAN08 14:05
                            HMRCCLIA 01.33 08FEB08 15:48
                            HMRCCMNA 01.28 29JAN08 14:05
                            HMRCCMND 01.28 29JAN08 14:05
                            HMRCCNCR 01.32 29JAN08 14:05
                            HMRCCOBD 01.10 29JAN08 14:06
                            HMRCCOBS 01.09 29JAN08 14:06
                            HMRCDEPO 01.15 29JAN08 14:06
                            HMRCDLYS 01.11 29JAN08 14:06
                            HMRCDMEC 01.35 20FEB08 15:16
                            HMRCDMEH 01.36 20FEB08 15:16
                            HMRCDMEL 01.37 20FEB08 15:16
                            HMRCDSMG 01.07 29JAN08 14:07
                            HMRCESRD 01.29 29JAN08 14:07
                            HMRCGHOD 01.31 29JAN08 14:07
                            HMRCGPRO 01.29 29JAN08 14:07
                            HMRCHCPC 01.33 08FEB08 15:48
                            HMRCHDR 01.33 29JAN08 14:07
                            HMRCHHEH 01.26 08FEB08 15:48
                            HMRCHMOC 01.32 08FEB08 15:48
                            HMRCHOSC 01.35 29JAN08 14:08
                            HMRCHOSD 01.34 29JAN08 14:08
                            HMRCHOSH 01.36 29JAN08 14:08
                            HMRCHOSL 01.36 29JAN08 14:08
                            HMRCHOSP 01.30 08FEB08 15:48
                            HMRCHOS1 01.36 08FEB08 15:49
                            HMRCHOS2 01.27 29JAN08 14:09
                            HMRCHOS4 01.30 29JAN08 14:09
                            HMRCINCR 01.18 29JAN08 14:09
                            HMRCINPA 01.33 29JAN08 14:09
                            HMRCINPD 01.32 29JAN08 14:09
                            HMRCINPH 01.36 29JAN08 14:09
                            HMRCINPL 01.35 29JAN08 14:09
                            HMRCLOPS 01.15 29JAN08 14:10
                            HMRCLUNG 01.28 29JAN08 14:10
                            HMRCMCCD 01.25 29JAN08 14:10
                            HMRCMSPA 01.30 29JAN08 14:10
                            HMRCMSPD 01.34 29JAN08 14:10
                            HMRCOUTD 01.33 29JAN08 14:10
                            HMRCOUTH 01.37 29JAN08 14:11
                            HMRCOUTL 01.36 29JAN08 14:11
                            HMRCOUTP 01.34 29JAN08 14:11
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix C: Software Release Files                                    Page 287
______________________________________________________________________________

 SITE     TYPE OF LIBRARY   MEMBER     VV.LL DATE    TIME TOTAL
 -------- ----------------- --------   ------------------- -----
                            HMRCPCHD   01.31 29JAN08 14:11
                            HMRCPCHL   01.35 29JAN08 14:11
                            HMRCPRVD   01.08 29JAN08 14:12
                            HMRCPRVN   01.07 29JAN08 14:12
                            HMRCPTBC   01.39 20FEB08 15:16
                            HMRCPTBH   01.40 20FEB08 15:16
                            HMRCPTBL   01.37 20FEB08 15:16
                            HMRCRNHC   01.26 29JAN08 14:12
                            HMRCSURG   01.31 29JAN08 14:12
                            HMRCTNIF   01.29 29JAN08 14:13
                            HMRCTRNG   01.21 29JAN08 14:13
                            HMRCVADE   01.13 29JAN08 14:13
                            HMRCVISN   01.08 29JAN08 14:13
                            HMRCXREF   01.29 29JAN08 14:13
                            HUBCCDUP   01.45 20FEB08 15:16
                            HUBCCED    01.69 25FEB08 09:47
                            HUBCCPHU   01.31 20FEB08 15:17
                            HUBCCUT    01.53 20FEB08 15:17
                            HUCNCRUT   01.52 20FEB08 15:17
                            HUCOBACR   01.18 20FEB08 15:17
                            HUESRDUT   01.17 25FEB08 09:47
                            HUIPCED    01.54 21JAN08 13:22
                            HUIPCUT    01.70 20FEB08 15:17
                            HUIPUPSH   01.36 29JAN08 10:35
                            HUOPCED    01.76 26FEB08 10:43
                            HUOPCUT    01.05 27FEB08 14:07
                            HUQACOP    01.28 08FEB08 15:50
                            HUTRNGUT   01.30 20FEB08 15:18
                            HUVISNUT   01.14 21FEB08 12:01
                                                             117
 HOST     PROC LIBRARY      UTLP82A0   01.00 05FEB08 10:48
                            UTLP82B0   01.00 15FEB08 11:04
                            UTLP82C0   01.00 15FEB08 11:04
                                                               3
 HOST     TABLES            CABHCPC    01.71 25FEB08 11:11
                                                               1
 HOST     UTILITY JCL       UTLJ82A0   01.00 05FEB08 10:48
                            UTLJ82B0   01.00 15FEB08 11:04
                            UTLJ82C0   01.00 15FEB08 11:04
                                                               3
                                                             162



______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix C: Software Release Files                                    Page 288
______________________________________________________________________________

 SITE     TYPE OF LIBRARY   MEMBER      VV.LL DATE    TIME TOTAL
 -------- ----------------- --------    ------------------- -----
 SATL     COPYLIB           CABEHIBC    01.23 20FEB08 15:05
                            CABEHUBC    01.25 20FEB08 15:05
                            HIMRCOMM    01.22 29JAN08 13:59
                            HIMRMAP     01.33 20FEB08 15:05
                                                                4
 SATL     ONLINE LOAD/COPY   HHRMHOS    01.03 29JAN08 13:59
                             HHRMMP1    01.04 29JAN08 13:59
                             HMRMCB2    01.06 09JAN08 11:18
                             HMRMDE4    01.11 20FEB08 15:06
                             HMRMHH1    01.04 08FEB08 15:43
                             HMRMHP1    01.04 08FEB08 15:43
                             HMRMPB4    01.11 20FEB08 15:06
                             HMRMVSN    01.04 29JAN08 13:59
                                                                8
 SATL     ONLINE LOADLIB     HHBPC00    01.26 29JAN08 14:14
                             HMRCCLPG   01.34 20FEB08 15:11
                             HMRCCONT   01.19 29JAN08 14:15
                             HMRCDUPN   01.16 29JAN08 14:15
                             HMRCHCPI   01.34 20FEB08 15:11
                             HMRCHMOI   01.34 20FEB08 15:11
                             HMRCMENU   01.27 29JAN08 14:16
                             HMRCMEN1   01.20 29JAN08 14:16
                             HMRCMEN2   01.21 29JAN08 14:18
                             HMRCSAT1   01.35 20FEB08 15:11
                             HMRCSAT2   01.46 27FEB08 14:07
                             HUTLERMS   01.13 29JAN08 14:19
                                                               12
 SATL     ONLINE/BATCH LOAD CABEDCMN    01.06 11JAN08 15:57
                                                                1
                                                               25
                                                              187




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix D: Customer Request/Element XREF Report                      Page 289
            Element/Customer Request XREF Report
______________________________________________________________________________

APPENDIX D:   CUSTOMER REQUEST/ELEMENT CROSS-REFERENCE REPORT

    CR         MEMBER       TOTAL
  NUMBER      CHANGED      MEMBERS
 --------     --------     --------
  C23761      HIBCCIP
              HIIPCIP
              HIIPCOP
              HIOPCIP
              HIOPCOP
                                 5
  C25445      HUOPCUT
              HUTRNGUT
              HUVISNUT
                                 3
  C25520      HIABCCR
                                 1
  C25567      HUIPUPSH
                                1
  C25598      CABBACHS
              CABBHRCV
              CABBHXMT
              CABBINPT
              CABBSPCL
              CABEHIBC
              CABEHUBC
              CAHOSTOT
              CIBLCLM
              CIOCPTB
              CIOPCLM
              HABBAUDT
              HABBHHMO
              HABBHIBC
              HABBHNDM
              HABWPCLM
              HABWPTBH
              HHEHUSPL
              HIABCCR
              HIABCCR2
              HIABNSOL
              HIABUNSL
              HIBCCIP
              HIBCCOP
              HIBCM02
              HICOCPR
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix D: Customer Request/Element XREF Report                      Page 290
            Element/Customer Request XREF Report
______________________________________________________________________________

   CR         MEMBER       TOTAL
 NUMBER      CHANGED      MEMBERS
--------     --------     --------
             HICRCBC
             HICRCDC
             HIDCCIP
             HIDCCOP
             HIDCM02
             HIMCMSPU
             HIMRMAP
             HMRCCLPG
             HMRCDMEC
             HMRCDMEH
             HMRCDMEL
             HMRCHCPI
             HMRCHMOI
             HMRCPTBC
             HMRCPTBH
             HMRCPTBL
             HMRCSAT1
             HMRMDE4
             HMRMPB4
             HUBCCDUP
             HUBCCED
             HUBCCPHU
             HUBCCUT
             HUCNCRUT
             HUCOBACR
             HUIPCUT
             HUOPCUT
             HUTRNGUT
             HUVISNUT
             LOADXITF
             UTILLOAD
             UTILPTRS
             UTLSAUX1
                               59
 C25623      HIABCCR
             HIABCCR2
                                2
 C25634      HIABCCR2
                                1
 C25640       CABCTAUX
              CABCVISN
              CIBPVISN
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix D: Customer Request/Element XREF Report                      Page 291
            Element/Customer Request XREF Report
______________________________________________________________________________

    CR         MEMBER       TOTAL
  NUMBER      CHANGED      MEMBERS
 --------     --------     --------
              CIOPVISN
              HABBHBBM
              HABBHIDL
              HABBHIID
              HABBHNDM
              HABWVISN
              HHBPC00
              HHRMBN1
              HHRMBN3
              HHRMHDR
              HHRMHOS
              HHRMMEN
              HHRMMP1
              HHRMMP2
              HHRMTLR
              HIMRCOMM
              HIMRMAP
              HMRCALIN
              HMRCBENA
              HMRCBENB
              HMRCBOD
              HMRCBOI
              HMRCCAPS
              HMRCCEPP
              HMRCCLIA
              HMRCCLPG
              HMRCCMNA
              HMRCCMND
              HMRCCNCR
              HMRCCOBD
              HMRCCOBS
              HMRCCONT
              HMRCDEPO
              HMRCDLYS
              HMRCDMEC
              HMRCDMEH
              HMRCDMEL
              HMRCDSMG
              HMRCDUPN
              HMRCESRD
              HMRCGHOD
              HMRCGPRO
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix D: Customer Request/Element XREF Report                      Page 292
            Element/Customer Request XREF Report
______________________________________________________________________________

    CR         MEMBER       TOTAL
  NUMBER      CHANGED      MEMBERS
 --------     --------     --------
              HMRCHCPC
              HMRCHCPI
              HMRCHDR
              HMRCHHEH
              HMRCHMOC
              HMRCHMOI
              HMRCHOSC
              HMRCHOSD
              HMRCHOSH
              HMRCHOSL
              HMRCHOSP
              HMRCHOS1
              HMRCHOS2
              HMRCHOS4
              HMRCINCR
              HMRCINPA
              HMRCINPD
              HMRCINPH
              HMRCINPL
              HMRCLOPS
              HMRCLUNG
              HMRCMCCD
              HMRCMENU
              HMRCMEN1
              HMRCMEN2
              HMRCMSPA
              HMRCMSPD
              HMRCOUTD
              HMRCOUTH
              HMRCOUTL
              HMRCOUTP
              HMRCPCHD
              HMRCPCHL
              HMRCPRVD
              HMRCPRVN
              HMRCPTBC
              HMRCPTBH
              HMRCPTBL
              HMRCRNHC
              HMRCSAT1
              HMRCSAT2
              HMRCSURG
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix D: Customer Request/Element XREF Report                      Page 293
            Element/Customer Request XREF Report
______________________________________________________________________________

   CR         MEMBER       TOTAL
 NUMBER      CHANGED      MEMBERS
--------     --------     --------
             HMRCTNIF
             HMRCTRNG
             HMRCVADE
             HMRCVISN
             HMRCXREF
             HMRMVSN
             HUBCCUT
             HUOPCUT
             HUTLERMS
             HUVISNUT
             HUVISNWA
             UTILLOAD
             UTILMOVE
             UTLJ82A0
             UTLP82A0
             UTLSAUX1
             UTLSUTUT
             UTLS82A0
             VISNAUX
                              106
 C25648      CABECOIF
             HMRCCOBD
             HMRCCOBS
             HMRCSAT1
             HMRCSAT2
             HMRMCB2
             HUBCCUT
             HUCOBACR
             HUIPCUT
             HUOPCUT
                               10
 C25649      HIABCCR2
             HIABUNSL
             HUIPCED
                                3
 C25651      CABEDCMN
             HUBCCED
             HUESRDUT
                                3
 C25652      HIABCCR2
             HIABUNSL
                                2
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix D: Customer Request/Element XREF Report                      Page 294
            Element/Customer Request XREF Report
______________________________________________________________________________

    CR         MEMBER       TOTAL
  NUMBER      CHANGED      MEMBERS
 --------     --------     --------
  C25665      HUIPCED
                                1
  C25718      CABBEMBD
              CABCHCHE
              CABCHHEH
              CIBPHHEH
              CIOPHHEH
              ELGACOP
              ELGBCOP
              ELGHCOP
              HABBAUDT
              HABBHCHE
              HABBHHMO
              HABBHIHO
              HABBHNDM
              HABWHHEH
              HHBPUSPL
              HHEHAUX
              HHEHUSPL
              HICRC00
              HICRMOP
              HIMRMAP
              HIQACOP
              HIQHCOP
              HMRCCLIA
              HMRCCLPG
              HMRCHCPC
              HMRCHCPI
              HMRCHHEH
              HMRCHMOC
              HMRCHMOI
              HMRCHOSP
              HMRCHOS1
              HMRCPTBC
              HMRCPTBH
              HMRCSAT1
              HMRMHH1
              HMRMHP1
              HUBCCUT
              HUOPCUT
              HUQACOP
              UTILMOVE
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix D: Customer Request/Element XREF Report                      Page 295
            Element/Customer Request XREF Report
______________________________________________________________________________

    CR         MEMBER       TOTAL
  NUMBER      CHANGED      MEMBERS
 --------     --------     --------
              UTLJ82B0
              UTLJ82C0
              UTLP82B0
              UTLP82C0
              UTLSAUX1
              UTLSUTUT
              UTLS82B0
              UTLS82C0
                               48
  C25786      CABHCPC
              HCPCSDME
              HUOPCED
                                3
                              248




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix D: Customer Request/Element XREF Report                      Page 296
            Element/Customer Request XREF Report
______________________________________________________________________________

  ELEMENT/CUSTOMER REQUEST CROSS-REFERENCE REPORT


  MEMBER         CR         TOTAL
 CHANGED       NUMBER      MEMBERS
 --------     --------     --------
 CABBACHS      C25598
                                1
 CABBEMBD      C25718
                                1
 CABBHRCV      C25598
                                1
 CABBHXMT      C25598
                                1
 CABBINPT      C25598
                                1
 CABBSPCL      C25598
                                1
 CABCHCHE      C25718
                                1
 CABCHHEH      C25718
                                1
 CABCTAUX      C25640
                                1
 CABCVISN      C25640
                                1
 CABECOIF      C25648
                                1
 CABEDCMN      C25651
                                1
 CABEHIBC      C25598
                                1
 CABEHUBC      C25598
                                1
 CABHCPC       C25786
                                1
 CAHOSTOT      C25598
                                1
 CIBLCLM       C25598
                                1
 CIBPHHEH      C25718
                                1
 CIBPVISN      C25640
                                1

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix D: Customer Request/Element XREF Report                      Page 297
            Element/Customer Request XREF Report
______________________________________________________________________________

 MEMBER         CR         TOTAL
CHANGED       NUMBER      MEMBERS
--------     --------     --------
CIOCPTB       C25598
                                1
CIOPCLM       C25598
                                1
CIOPHHEH      C25718
                                1
CIOPVISN      C25640
                                1
ELGACOP       C25718
                                1
ELGBCOP       C25718
                                1
ELGHCOP       C25718
                                1
HABBAUDT      C25598
              C25718
                                2
HABBHBBM      C25640
                                1
HABBHCHE      C25718
                                1
HABBHHMO      C25598
              C25718
                                2
HABBHIBC      C25598
                                1
HABBHIDL      C25640
                                1
HABBHIHO      C25718
                                1
HABBHIID      C25640
                                1
HABBHNDM      C25598
              C25640
              C25718
                                3
HABWHHEH      C25718
                                1
HABWPCLM      C25598
                                1
HABWPTBH      C25598
                                1
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix D: Customer Request/Element XREF Report                      Page 298
            Element/Customer Request XREF Report
______________________________________________________________________________

 MEMBER         CR         TOTAL
CHANGED       NUMBER      MEMBERS
--------     --------     --------
HABWVISN      C25640
                                1
HCPCSDME      C25786
                                1
HHBPC00       C25640
                                1
HHBPUSPL      C25718
                                1
HHEHAUX       C25718
                                1
HHEHUSPL      C25598
              C25718
                                2
HHRMBN1       C25640
                                1
HHRMBN3       C25640
                                1
HHRMHDR       C25640
                                1
HHRMHOS       C25640
                                1
HHRMMEN       C25640
                                1
HHRMMP1       C25640
                                1
HHRMMP2       C25640
                                1
HHRMTLR       C25640
                                1
HIABCCR       C25520
              C25598
              C25623
                                3
HIABCCR2      C25598
              C25623
              C25634
              C25649
              C25652
                                5
HIABNSOL      C25598
                                1

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix D: Customer Request/Element XREF Report                      Page 299
            Element/Customer Request XREF Report
______________________________________________________________________________

  MEMBER         CR         TOTAL
 CHANGED       NUMBER      MEMBERS
 --------     --------     --------
 HIABUNSL      C25598
               C25649
               C25652
                                3
 HIBCCIP       C23761
               C25598
                                2
 HIBCCOP       C25598
                                1
 HIBCM02       C25598
                                1
 HICOCPR       C25598
                                1
 HICRCBC       C25598
                                1
 HICRCDC       C25598
                                1
 HICRC00       C25718
                                1
 HICRMOP       C25718
                                1
 HIDCCIP       C25598
                                1
 HIDCCOP       C25598
                                1
 HIDCM02       C25598
                                1
 HIIPCIP       C23761
                                1
 HIIPCOP       C23761
                                1
 HIMCMSPU      C25598
                                1
 HIMRCOMM      C25640
                                1
 HIMRMAP       C25598
               C25640
               C25718
                                3
 HIOPCIP       C23761
                                1

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix D: Customer Request/Element XREF Report                      Page 300
            Element/Customer Request XREF Report
______________________________________________________________________________

  MEMBER         CR         TOTAL
 CHANGED       NUMBER      MEMBERS
 --------     --------     --------
 HIOPCOP       C23761
                                1
 HIQACOP       C25718
                                1
 HIQHCOP       C25718
                                1
 HMRCALIN      C25640
                                1
 HMRCBENA      C25640
                                1
 HMRCBENB      C25640
                                1
 HMRCBOD       C25640
                                1
 HMRCBOI       C25640
                                1
 HMRCCAPS      C25640
                                1
 HMRCCEPP      C25640
                                1
 HMRCCLIA      C25640
               C25718
                                2
 HMRCCLPG      C25598
               C25640
               C25718
                                3
 HMRCCMNA      C25640
                                1
 HMRCCMND      C25640
                                1
 HMRCCNCR      C25640
                                1
 HMRCCOBD      C25640
               C25648
                                2
 HMRCCOBS      C25640
               C25648
                                2
 HMRCCONT      C25640
                                1

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix D: Customer Request/Element XREF Report                      Page 301
            Element/Customer Request XREF Report
______________________________________________________________________________

  MEMBER         CR         TOTAL
 CHANGED       NUMBER      MEMBERS
 --------     --------     --------
 HMRCDEPO      C25640
                                1
 HMRCDLYS      C25640
                                1
 HMRCDMEC      C25598
               C25640
                                2
 HMRCDMEH      C25598
               C25640
                                2
 HMRCDMEL      C25598
               C25640
                                2
 HMRCDSMG      C25640
                                1
 HMRCDUPN      C25640
                                1
 HMRCESRD      C25640
                                1
 HMRCGHOD      C25640
                                1
 HMRCGPRO      C25640
                                1
 HMRCHCPC      C25640
               C25718
                                2
 HMRCHCPI      C25598
               C25640
               C25718
                                3
 HMRCHDR       C25640
                                1
 HMRCHHEH      C25640
               C25718
                                2
 HMRCHMOC      C25640
               C25718
                                2
 HMRCHMOI      C25598
               C25640
               C25718
                                3
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix D: Customer Request/Element XREF Report                      Page 302
            Element/Customer Request XREF Report
______________________________________________________________________________

  MEMBER         CR         TOTAL
 CHANGED       NUMBER      MEMBERS
 --------     --------     --------
 HMRCHOSC      C25640
                                1
 HMRCHOSD      C25640
                                1
 HMRCHOSH      C25640
                                1
 HMRCHOSL      C25640
                                1
 HMRCHOSP      C25640
               C25718
                                2
 HMRCHOS1      C25640
               C25718
                                2
 HMRCHOS2      C25640
                                1
 HMRCHOS4      C25640
                                1
 HMRCINCR      C25640
                                1
 HMRCINPA      C25640
                                1
 HMRCINPD      C25640
                                1
 HMRCINPH      C25640
                                1
 HMRCINPL      C25640
                                1
 HMRCLOPS      C25640
                                1
 HMRCLUNG      C25640
                                1
 HMRCMCCD      C25640
                                1
 HMRCMENU      C25640
                                1
 HMRCMEN1      C25640
                                1
 HMRCMEN2      C25640
                                1
 HMRCMSPA      C25640
                                1
______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix D: Customer Request/Element XREF Report                      Page 303
            Element/Customer Request XREF Report
______________________________________________________________________________

 MEMBER         CR         TOTAL
CHANGED       NUMBER      MEMBERS
--------     --------     --------
HMRCMSPD      C25640
                                1
HMRCOUTD      C25640
                                1
HMRCOUTH      C25640
                                1
HMRCOUTL      C25640
                                1
HMRCOUTP      C25640
                                1
HMRCPCHD      C25640
                                1
HMRCPCHL      C25640
                                1
HMRCPRVD      C25640
                                1
HMRCPRVN      C25640
                                1
HMRCPTBC      C25598
              C25640
              C25718
                                3
HMRCPTBH      C25598
              C25640
              C25718
                                3
HMRCPTBL      C25598
              C25640
                                2
HMRCRNHC      C25640
                                1
HMRCSAT1      C25598
              C25640
              C25648
              C25718
                                4
HMRCSAT2      C25640
              C25648
                                2
HMRCSURG      C25640
                                1

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix D: Customer Request/Element XREF Report                      Page 304
            Element/Customer Request XREF Report
______________________________________________________________________________

 MEMBER         CR         TOTAL
CHANGED       NUMBER      MEMBERS
--------     --------     --------
HMRCTNIF      C25640
                                1
HMRCTRNG      C25640
                                1
HMRCVADE      C25640
                                1
HMRCVISN      C25640
                                1
HMRCXREF      C25640
                                1
HMRMCB2       C25648
                                1
HMRMDE4       C25598
                                1
HMRMHH1       C25718
                                1
HMRMHP1       C25718
                                1
HMRMPB4       C25598
                                1
HMRMVSN       C25640
                                1
HUBCCDUP      C25598
                                1
HUBCCED       C25598
              C25651
                                2
HUBCCPHU      C25598
                                1
HUBCCUT       C25598
              C25640
              C25648
              C25718
                                4
HUCNCRUT      C25598
                                1
HUCOBACR      C25598
              C25648
                                2
HUESRDUT      C25651
                                1

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix D: Customer Request/Element XREF Report                      Page 305
            Element/Customer Request XREF Report
______________________________________________________________________________

 MEMBER         CR         TOTAL
CHANGED       NUMBER      MEMBERS
--------     --------     --------
HUIPCED       C25649
              C25665
                                2
HUIPCUT       C25598
              C25648
                                2
HUIPUPSH      C25567
                                1
HUOPCED       C25786
                                1
HUOPCUT       C25445
              C25598
              C25640
              C25648
              C25718
                                5
HUQACOP       C25718
                                1
HUTLERMS      C25640
                                1
HUTRNGUT      C25445
              C25598
                                2
HUVISNUT      C25445
              C25598
              C25640
                                3
HUVISNWA      C25640
                                1
LOADXITF      C25598
                                1
UTILLOAD      C25598
              C25640
                                2
UTILMOVE      C25640
              C25718
                                2
UTILPTRS      C25598
                                1
UTLJ82A0      C25640
                                1

______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland
Common Working File                                                   R2008200
Host Quarterly Release Document                                  March 4, 2008
Appendix D: Customer Request/Element XREF Report                      Page 306
            Element/Customer Request XREF Report
______________________________________________________________________________

  MEMBER         CR         TOTAL
 CHANGED       NUMBER      MEMBERS
 --------     --------     --------
 UTLJ82B0      C25718
                                1
 UTLJ82C0      C25718
                                1
 UTLP82A0      C25640
                                1
 UTLP82B0      C25718
                                1
 UTLP82C0      C25718
                                1
 UTLSAUX1      C25598
               C25640
               C25718
                                3
 UTLSUTUT      C25640
               C25718
                                2
 UTLS82A0      C25640
                                1
 UTLS82B0      C25718
                                1
 UTLS82C0      C25718
                                1
 VISNAUX       C25640
                                1
                              248




______________________________________________________________________________
2020 Company, LLC                                          Baltimore, Maryland

				
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