oc8f38lb2bdx~notused~CSSC Operations will be closed Monday, January 18, 2021 in observance of the Martin Luther King Jr. holiday. The Front-End Systems (FERAS, PDFS, and EDFES) will be available during this time for RAPS, PDE, Medicare Encounter and Medicare-Medicaid data submissions.~none~_blank~blue~01-12-2021 12:40~01-20-2021 06:00||oc8f38lb2bcc~notused~CSSC Operations will be closed Monday, May 31, 2021 in observance of the Memorial day holiday. The Front-End Systems (FERAS, PDFS, and EDFES) will be available during this time for RAPS, PDE, Medicare Encounter and Medicare-Medicaid data submissions.~none~_blank~blue~05-27-2021 12:40~06-01-2021 06:00||cje8ri2xp9zd~notused~CSSC Operations will be closed Monday, July 5, 2021 in observance of the Independence Day holiday. The Front-End Systems (FERAS, PDFS, and EDFES) will be available during this time for RAPS, PDE, Medicare Encounter and Medicare-Medicaid data submissions.~~_blank~blue~07-01-2021 06:00~07-06-2021 06:00||cje8ri2xp9dd~notused~CSSC Operations will be closed Monday, September 6, 2021 in observance of the Labor Day holiday. The Front-End Systems (FERAS, PDFS, and EDFES) will be available during this time for RAPS, PDE, Medicare Encounter and Medicare-Medicaid data submissions.~~_blank~blue~09-03-2021 06:00~09-07-2021 06:00||3samv18vpxkk~notused~CSSC Operations will be closed Thursday, November 25, 2020 and Friday, November 25, 2020 in observance of the Thanksgiving holiday. The Front-End Systems (FERAS, PDFS, and EDFES) will be available during this time for RAPS, PDE, Medicare Encounter and Medicare-Medicaid data submissions.~none~_blank~blue~11-23-2021 07:00~11-28-2021 07:00||p35y937gpjsx~notused~CSSC Operations will be closed Friday, December 23, 2021 and Monday, December 27, 2021 in observance of the Christmas holiday. The Front-End Systems (FERAS, PDFS, and EDFES) will be available during this time for RAPS, PDE, Medicare Encounter and Medicare-Medicaid data submissions~none~_blank~blue~12-22-2021 07:00~12-28-2021 07:00||vpphkwmwueaa~notused~CSSC Operations will be closed Friday, December 31, 2021 in observance of the New Year's Day holiday. The Front-End Systems (FERAS, PDFS, and EDFES) will be available during this time for RAPS, PDE, Medicare Encounter and Medicare-Medicaid data submissions.~none~_blank~blue~12-28-2021 07:00~01-02-2022 07:00
How does CMS determine a diagnosis code's highest level of specificity for a specific beneficiary when generating edit 255 ‘Diagnosis Code’?
Answer:
To pass Encounter Data Front End System (EDFES) edits, diagnoses codes must be valid codes for the respective date of service and should be coded to the highest level of specificity, meaning to the maximum number of digits available for the codes, in the valid code set. The edits used are similar to those used in Original Medicare, so you may refer to the CMS Medical Learning Network (MLN) Publications Medicare Billing: 837P and Form CMS-1500 (October 2016) and Medicare Billing: 837I and CMS Form 1450 (April 2016),which provide references to the relevant guidance in the “Medicare Claims Processing Manual” for guidance on coding specificity requirements.