Medicaid Managed Care Program Information
Change Log
- Log is also available in Portable Document Format (PDF)
Change Log as of February 26, 2016
| Current Page # | Data Element | Change |
|---|---|---|
| 342 | Provider and Ancillary/Service Specialty Codes | Added provider/ancillary codes: 835 HCBS PROVIDER TRAVEL 836 HCBS PSYCHOSOCIAL REHAB 837 HCBS PEER SUPPORT 838 OMH OTHER LICENSED PRACTITIONERS 839 HCBS COMMUNITY PSYCHIATRIC SUPPORTS AND TREATMENT |
Change Log as of September 17, 2015
| Current Page # | Data Element | Change |
|---|---|---|
| 213 | Appendix A – Provider Profession Codes | Added behavioral health specialty codes 854–862 |
Change Log as of July 29, 2015
| Current Page # | Data Element | Change |
|---|---|---|
| 142 | Pharmacy Segment – Edit Applications | Edit 02193 has been added to this data element. |
| 232 | Edit Logic – 02193 Controlled Substance Limit Exceeded | Added Edit Code 02193 Controlled Substance Limit Exceeded and its logic. |
| 245 | Edit Severity Matrix – 02193 Controlled Substance Limit Exceeded | Added Edit Code 02193 Controlled Substance Limit Exceeded and its logic. |
Change Log as of March 24, 2015
| Current Page # | Data Element | Change |
|---|---|---|
| 243 | Edit Logic – 01724 | Nursing Home COS 12 and 73 changed from Hard Edit "H" to Non–Edit "N". |
Change Log as of February 26, 2015
| Current Page # | Data Element | Change |
|---|---|---|
| 1 | Version Number | Version changed to 3.4, December 2014. |
| 1 | Contact Information | Updated the contact information on cover page. |
| 7 | Reporting | "Encounter files must be submitted monthly…" has been changed to: "Encounter files are to be submitted in accordance with the model contract…" |
| 8 | 2015 Data Extract Schedule | 2015 Data Extract dates have been added. |
| 204–205 | APPENDIX A – Provider Profession Codes | Added Behavioral Health profession codes 071 and 078. |
| 206–217 | APPENDIX B – Provider Specialty Codes | Added nursing home provider specialty codes 655–659. Added FIDA specialty codes 816–834. |
| 224–232 | Edit Logic | Edit codes 00076, 00132, 00162, 00204, 00240, 00263, 00401, 00402, 00411, 00414, 00415, 00422, 00627, 00653, 00736, 00737, 01042, 01044, 01046, 01073, 01292, 01714, 01724, 02030, 02031, 02036, 02037 and 02038 have been added. |
| 234–246 | Edit Severity Matrix (code changes) | Edit code 00078 – REFERRING PROVIDER ID NUMBER INVALID has been changed to a N=Non–Edit (Ignore) for Pharmacy. Edit Code 00544 – NDC CODE NON–NUMERIC has been changed to a H=Hard–edit (Deny) for Pharmacy. Edit Code 00561 – NDC CODE NON–NUMERIC has been changed to a H=Hard–edit (Deny) for Clinical encounters. Edit Code 02066– DRUG CODE MISSING has been changed to a H=Hard–edit (Deny) for Clinical encounters. |
| 235–247 | Edit Severity Matrix (new codes) | Edit codes 00076, 00132, 00162, 00204, 00240, 00263, 00401, 00402, 00411, 00414, 00415, 00422, 00627, 00653, 00736, 00737, 01042, 01044, 01046, 01073, 01292, 01714, 01724, 02030, 02031, 02036, 02037 and 02038 have been added. Note: These codes have already been in effect but were not reflected in the data dictionary. |
Change Log as of July 21, 2014
| Current Page # | Data Element | Change |
|---|---|---|
| 241, 245 | Edit Severity Matrix | Edit codes 00544, 00561 and 02066 have been modified to trigger a hard edit for pharmacy encounters. |
Change Log as of April 24, 2014
| Current Page # | Data Element | Change |
|---|---|---|
| 26 | MEDS III Data Element Reporting – Institutional Segment – Discharge Date | Added category of service codes 12 (Institutional LTC) and 28 (Intermediate Care Facilities) to be required in submission. |
| 235 | Edit Logic – 01724 Line DOS Outside from/Through Dates | New edit logic for institutional encounters to prevent inconsistency in header service dates. |
| 244 | Edit Severity Matrix – 01724 Line DOS Outside from/Through Dates | New edit logic for institutional encounters to prevent inconsistency in header service dates. |
Change Log as of February 10, 2014
| Current Page # | Data Element | Change |
|---|---|---|
| 1 | Data Dictionary Version Number | Version number changed to 3.3, February 2014. |
| 7 | Version Number – Date | Updated to version 3.3, February 2014. |
| 8 | 2014 Data Extract Schedule | Data extract schedule updated to 2014 values. |
| 15 | MEDS Data Element Reporting – Provider Service Location | Submission status is now ´Required´, previously this cell was blank. |
| 74 | MEDS III Transaction Segment: Common Detail – Provider Service Location | Removed the word ´partial´ to prevent issues of interpretation in the definition. This data element requires a valid, complete, 9–digit U.S. zip code. |
| 222–225 | Edit Logic – 00705 Duplicate Claim In History | Detailed the system´s logic for how/why specific claim encounters will fail to process. |
