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February 24, 2004
 CMS Manual System:
Medicare Claims Processing Summary of Changes
Shared systems
changes are needed to process the 837 Institutional X12N HIPAA
claim transaction correctly. A number of issues with Coordination
of Benefits (COB) transactions with third party payers, including
states, have emerged as Medicare has implemented HIPAA transaction
and code set standards. Some of these issues stem from Medicare
having unique claims processing rules that differ from those used
by other payers. We made a number of system and data element
changes to implement the HIPAA standards, but some issues were not
evident until testing with COB partners began. The claims Medicare
sends out for COB are viewed as incoming claims by other payers.
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