Corrections to Final Rule, Published November 24, 2000 Read more.

PREAMBLE:

• Summary and Introduction
• Background
• General Overview of the Provisions of the Proposed Rule
• Analysis of, and Responses to, Public Comments on the Proposed Rule
• Summary of Changes to the Regulations
• Collection of Information Requirements
• Final Impact Analysis
• Federalism
• Interaction with Privacy

REGULATION TEXT:

SUBCHAPTER C- ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS

• PART 160 – GENERAL ADMINISTRATIVE REQUIREMENTS
• Subpart A – General Provisions
• 160.101 Statutory basis and purpose.
• 160.102 Applicability.
• 160.103 Definitions.
• 160.104 Modifications.
• Subpart B – [RESERVED]
• PART 162--ADMINISTRATIVE REQUIREMENTS
• Subpart A--General Provisions
• 162.100 Applicability.
• 162.103 Definitions.
• Subparts B - H [RESERVED]
• Subpart I - General Provisions for Transactions
• 162.900 Compliance dates of the initial implementation of the code sets and transaction standards.
• 162.910 Maintenance of standards and adoption of modifications and new standards.
• 162.915 Trading partner agreements.
• 162.920 Availability of implementation specifications.
• 162.923 Requirements for covered entities.
• 162.925 Additional requirements for health plans.
• 162.930 Additional rules for health care clearinghouses.
• 162.940 Exceptions from standards to permit testing of proposed modifications.
• Subpart J - Code Sets
• 162.1000 General requirements.
• 162.1002 Medical data code sets.
• 162.1011 Valid code sets.
• Subpart K - Health Care Claims or Equivalent Encounter Information
• 162.1101 Health care claims or equivalent encounter information transaction.
• 162.1102 Standards for health care claims or equivalent encounter information.
• Subpart L - Eligibility for a Health Plan
• 162.1201 Eligibility for a health plan transaction.
• 162.1202 Standards for eligibility for a health plan.
• Subpart M - Referral Certification and Authorization
• 162.1301 Referral certification and authorization transaction.
• 162.1302 Standard for referral certification and authorization.
• Subpart N - Health Care Claim Status
• 162.1401 Health care claim status transaction.
• 162.1402 Standard for health care claim status.
• Subpart O - Enrollment and Disenrollment in a Health Plan
• 162.1501 Enrollment and disenrollment in a health plan transaction.
• 162.1502 Standard for enrollment and disenrollment in a health plan.
• Subpart P - Health Care Payment and Remittance Advice
• 162.1601 Health care payment and remittance advice transaction.
• 162.1602 Standards for health care payment and remittance advice.
• Subpart Q - Health Plan Premium Payments
• 162.1701 Health plan premium payments transaction.
• 162.1702 Standard for health plan premium payments.
• Subpart R - Coordination of Benefits
• 162.1801 Coordination of benefits transaction.
• 162.1802 Standards for coordination of benefits.

Announcement of Designated Standard Maintenance Organizations