Part 162 - ADMINISTRATIVE REQUIREMENTS  


Subparts B-C [Reserved]
Subparts G-H [Reserved]
Subpart A — General Provisions
§ 162.100 Applicability.
§ 162.103 Definitions.
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.
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.

Authority

Secs. 1171 through 1180 of the Social Security Act (42 U.S.C. 1320d–1320d–9), as added by sec. 262 of Pub. L. 104–191, 110 Stat. 2021–2031, sec. 105 of Pub. L. 110–233, 122 Stat. 881–922, and sec. 264 of Pub. L. 104–191, 110 Stat. 2033–2034 (42 U.S.C. 1320d–2(note), and secs. 1104 and 10109 of Pub. L. 111–148, 124 Stat. 146–154 and 915–917.

Source

65 FR 50367, Aug. 17, 2000, unless otherwise noted.