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June 14, 2018

Fiscal Intermediary Standard System (FISS) Direct Data Entry (DDE) Screen Changes

The July 2018 quarterly system release, which will be implemented on July 2, 2018, includes changes to some FISS DDE screens. As a result, the Part A DDE User Manual/Reference Guide and the home health and hospice FISS DDE Guide have been updated. Below is a summary of those changes.

Chapter Three: Inquiry Menu, Beneficiary/CWF (Option 10) – This option provides beneficiary eligibility information. Previously CGS only provided information about Map 1751 where you enter the beneficiary Medicare number, last name, first name, sex, and date of birth. This chapter was updated to include all of the eligibility screens available under Option 10. With the July 2018 system release, Map157J was updated by adding the field SETS/93668. This will display the number of SET sessions that remain.

Chapter Four: Claims and Attachments Menu, Claims/Attachments (Option 02) – Two new fields, ADJ MBI and IND, were added to Page 03 (Map 1713) of the Claim Entry screen. In addition, the NDC CODE was changed to NDC CD and the OFFSITE ZIPCODE field was changed to OFFSITE ZIP. The following provides the field name and description.

NDC CD

National drug code. Not used by home health or hospice providers.

OFFSITE ZIP

This field identifies offsite Clinic/Outpatient department zip codes. It determines the claim line HPSA/PSA bonus eligibility.

Note: When a zip code is present, the system uses the zip code for processing, not the zip code for the base provider (CAH). Indicating that one of the off-site clinics/outpatient departments submitted the claim for payment and not the base provider (CAH).

Not applicable to home health and hospice providers.

ADJ MBI

Identifies the submitted ID indicator and submitted Medicare Beneficiary Identifier on adjustments and cancels.

IND

Auto populated with an M on adjustments and cancels when the MBI is entered on MAP1741 (Claim Summary Inquiry) screen. An H will display on adjustments and cancels when a HIC is entered on MAP1741.

Chapter Five: Claims Correction – This document was updated to reflect the screen changes to Map 1713, as described above.

As mentioned, these changes will be effective on July 2, 2018. For details about FISS DDE, refer to the Part A DDE User Manual/Reference Guide Web page or the home health and hospice FISS DDE Guide Web page.

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