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Code of Federal Regulations (Last Updated: July 5, 2024) |
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Title 45 - Public Welfare |
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Subtitle A - Department of Health and Human Services |
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SubChapter C - Administrative Data Standards and Related Requirements |
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Part 162 - Administrative Requirements |
| Subpart A - General Provisions |
| § 162.100 - Applicability. |
| § 162.103 - Definitions. |
| Subparts B--C - XXX |
| Subpart D - Standard Unique Health Identifier for Health Care Providers |
| § 162.402 - [Reserved] |
| § 162.404 - Compliance dates of the implementation of the standard unique health identifier for health care providers. |
| § 162.406 - Standard unique health identifier for health care providers. |
| § 162.408 - National Provider System. |
| § 162.410 - Implementation specifications: Health care providers. |
| § 162.412 - Implementation specifications: Health plans. |
| § 162.414 - Implementation specifications: Health care clearinghouses. |
| Subpart E - Standard Unique Health Identifier for Health Plans |
| § 162.502 - [Reserved] |
| § 162.504 - Compliance requirements for the implementation of the standard unique health plan identifier. |
| § 162.506 - Standard unique health plan identifier. |
| § 162.508 - Enumeration System. |
| § 162.510 - Full implementation requirements: Covered entities. |
| § 162.512 - Implementation specifications: Health plans. |
| § 162.514 - Other entity identifier. |
| Subpart F - Standard Unique Employer Identifier |
| § 162.600 - Compliance dates of the implementation of the standard unique employer identifier. |
| § 162.605 - Standard unique employer identifier. |
| § 162.610 - Implementation specifications for covered entities. |
| Subparts G--H - XXX |
| Subpart I - General Provisions for Transactions |
| § 162.900 - [Reserved] |
| § 162.910 - Maintenance of standards and adoption of modifications and new standards. |
| § 162.915 - Trading partner agreements. |
| § 162.920 - Availability of implementation specifications and operating rules. |
| § 162.923 - Requirements for covered entities. |
| § 162.925 - Additional requirements for health plans. |
| § 162.930 - Additional rules for health care clearinghouses. |
| § 162.940 - Exceptions from standards to permit testing of proposed modifications. |
| Subpart J - Code Sets |
| § 162.1000 - General requirements. |
| § 162.1002 - Medical data code sets. |
| § 162.1011 - Valid code sets. |
| Subpart K - Health Care Claims or Equivalent Encounter Information |
| § 162.1101 - Health care claims or equivalent encounter information transaction. |
| § 162.1102 - Standards for health care claims or equivalent encounter information transaction. |
| Subpart L - Eligibility for a Health Plan |
| § 162.1201 - Eligibility for a health plan transaction. |
| § 162.1202 - Standards for eligibility for a health plan transaction. |
| § 162.1203 - Operating rules for eligibility for a health plan transaction. |
| Subpart M - Referral Certification and Authorization |
| § 162.1301 - Referral certification and authorization transaction. |
| § 162.1302 - Standards for referral certification and authorization transaction. |
| Subpart N - Health Care Claim Status |
| § 162.1401 - Health care claim status transaction. |
| § 162.1402 - Standards for health care claim status transaction. |
| § 162.1403 - Operating rules for health care claim status transaction. |
| Subpart O - Enrollment and Disenrollment in a Health Plan |
| § 162.1501 - Enrollment and disenrollment in a health plan transaction. |
| § 162.1502 - Standards for enrollment and disenrollment in a health plan transaction. |
| Subpart P - Health Care Electronic Funds Transfers (EFT) and Remittance Advice |
| § 162.1601 - Health care electronic funds transfers (EFT) and remittance advice transaction. |
| § 162.1602 - Standards for health care electronic funds transfers (EFT) and remittance advice transaction. |
| § 162.1603 - Operating rules for health care electronic funds transfers (EFT) and remittance advice transaction. |
| Subpart Q - Health Plan Premium Payments |
| § 162.1701 - Health plan premium payments transaction. |
| § 162.1702 - Standards for health plan premium payments transaction. |
| Subpart R - Coordination of Benefits |
| § 162.1801 - Coordination of benefits transaction. |
| § 162.1802 - Standards for coordination of benefits information transaction. |
| Subpart S - Medicaid Pharmacy Subrogation |
| § 162.1901 - Medicaid pharmacy subrogation transaction. |
| § 162.1902 - Standard for Medicaid pharmacy subrogation transaction. |