CMS Standard File for Reason Codes

60.1 - CMS Standard File for Reason Codes (Rev. 59, Issued: 10-30-09, Effective: 04-01-10, Implementation: 04-05-10) The A/B MAC (A) or (HHH) Edits Evaluation Workgroup is tasked with identifying the inventory of contractor inactivated edits, documenting the reasons why the edits are turned off, and making a decision as to whether they should remain inactive or not. Transmittal 338, (Change Request (CR) 5927) issued on May 2, 2008, created the ‘CMS Standard’ field within the existing FISS Reason Code File which contains the status that was determined by the A/B MAC (A) or (HHH) Edits Evaluation Workgroup for each individual code that was reviewed. The ‘CMS Standard’ field indicators are as follows: • ‘A’ = Active • ‘I’ = Inactive • ‘ ‘ = Blank NOTE: The terms ‘Active’ & ‘Inactive‘ are defined as: • Active = Reason code status is equal to ‘S’, ‘P’, ‘ ‘ (blank), ‘D’, ‘R’, ‘T’, or is not equal to ‘S MDLTD’; and • Inactive = Reason code status is equal to ‘A’ or is equal to ‘S MDLTD.’ Each quarter, as necessary, CMS will issue an updated CMS Standard File for Reason Codes which is loaded into the system by the FISS maintainer via a Recurring Update Notification.