ExamWorks Clinical Solutions Will Implement New File Specifications
Thursday, February 12, 2015
Over the last year, the Centers for Medicare & Medicaid Services (CMS) has issued three key Alerts related to Mandatory Insurer Reporting.
- November 25, 2014 - Reporting Partial Social Security Numbers.
- November 10, 2014 - Submitting Recovery Agent Information for MSP Recovery.
- May 13, 2014 - ICD-10 code implementation was delayed until October 1, 2015.
To accommodate the changes made by CMS and to improve the services offered by ExamWorks Clinical Solutions (ECS), we are implementing a new file specification titled, "ECS MIR Customer File Spec v4." The following list of changes should be reviewed in great detail.
New File Specification Implementation Time Line:
- April 1, 2015 - Clients can begin submitting the New ECS File Specification in the Test Environment.
- July 1, 2015 - Clients can begin submitting the New ECS File Specification in the Production Environment.
- December 31, 2015 -Support for Existing File Specification titled (GL MIR Customer File Spec 05152013) will no longer be supported; ECS recommends submitting the New ECS File Specification prior to 10/1/2015.
- ICD-10 Alleged Cause of Injury Code
- ICD-10 Code fields
- User Defined Fields
- Adjuster Fields
- Recovery Agent Fields
Existing Field Modification:
- Added Claim Number to Customer Eligibility Input file
- Added "D" to the list of values for Medicare Eligibility
- Updated definition of MIR Reportable
- Removed CPR Indicator field and replaced with Reserved for Future Use
Important Note Regarding ICD-10:
CMS requires ICD-10 codes for claims with a date of injury on or after October 1, 2015. You can report ICD-10 codes on claims with a date of injury prior to 10/1/2015. Please note if you submit both ICD-9 and CD-10 codes, we will only validate and submit the ICD-10 codes.
Please contact your MMSEA Compliance Manager with any questions at email@example.com or 866-672-3453 x 1122.