Hospital CMS internet-only manuals (IOMs)

Hospital (Inpatient and Outpatient)

CMS internet-only manuals (IOMs)

CMS IOMs contain day-to-day operating instructions, policies, and procedures based on statutes, regulations, guidelines, models, and directives. Search the CMS manuals for information related to hospitals.

Inpatient/Outpatient CMS manuals

• Publication 100-04 -- Medicare Claims Processing Manual
  • Chapter 22 -- Remittance Advice 
  • Chapter 24 -- General Electronic Data Interchange (EDI) and EDI Support Requirements, Electronic Claims and Coordination of Benefits Requirements, Mandatory Electronic Filing of Medicare Claims 
  • Chapter 25 -- Completing and Processing the Form CMS-1450 Data Set 
  • Chapter 29 -- Appeals of Claims Decisions

Inpatient CMS manuals

• Publication 100-04 -- Medicare Claims Processing Manual
  • Chapter 3 -- Inpatient Hospital Billing

Outpatient CMS manuals

• Publication 100-04 -- Medicare Claims Processing Manual
  • Chapter 4 -- Part B Hospital (Including inpatient hospital Part B and OPPS)