Title 45

PART 162 Part 162 - Administrative Requirements

PART 162 - ADMINISTRATIVE REQUIREMENTS Authority:42 U.S.C. 1320d - 1320d-9 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.

Authority: 42 U.S.C. 1320d - 1320d-9 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.

45:2.0.1.2.19.1	SUBPART A	Subpart A - General Provisions
45:2.0.1.2.19.1.1.1	SECTION 162.100	162.100 Applicability.
45:2.0.1.2.19.1.1.2	SECTION 162.103	162.103 Definitions.
45:2.0.1.2.19.2	SUBPART B	Subparts B-C [Reserved]
45:2.0.1.2.19.3	SUBPART D	Subpart D - Standard Unique Health Identifier for Health Care Providers
45:2.0.1.2.19.3.1.1	SECTION 162.402	162.402 [Reserved]
45:2.0.1.2.19.3.1.2	SECTION 162.404	162.404 Compliance dates of the implementation of the standard unique health identifier for health care providers.
45:2.0.1.2.19.3.1.3	SECTION 162.406	162.406 Standard unique health identifier for health care providers.
45:2.0.1.2.19.3.1.4	SECTION 162.408	162.408 National Provider System.
45:2.0.1.2.19.3.1.5	SECTION 162.410	162.410 Implementation specifications: Health care providers.
45:2.0.1.2.19.3.1.6	SECTION 162.412	162.412 Implementation specifications: Health plans.
45:2.0.1.2.19.3.1.7	SECTION 162.414	162.414 Implementation specifications: Health care clearinghouses.
45:2.0.1.2.19.4	SUBPART E	Subpart E [Reserved]
45:2.0.1.2.19.5	SUBPART F	Subpart F - Standard Unique Employer Identifier
45:2.0.1.2.19.5.1.1	SECTION 162.600	162.600 Compliance dates of the implementation of the standard unique employer identifier.
45:2.0.1.2.19.5.1.2	SECTION 162.605	162.605 Standard unique employer identifier.
45:2.0.1.2.19.5.1.3	SECTION 162.610	162.610 Implementation specifications for covered entities.
45:2.0.1.2.19.6	SUBPART G	Subparts G-H [Reserved]
45:2.0.1.2.19.7	SUBPART I	Subpart I - General Provisions for Transactions
45:2.0.1.2.19.7.1.1	SECTION 162.900	162.900 [Reserved]
45:2.0.1.2.19.7.1.2	SECTION 162.910	162.910 Maintenance of standards and adoption of modifications and new standards.
45:2.0.1.2.19.7.1.3	SECTION 162.915	162.915 Trading partner agreements.
45:2.0.1.2.19.7.1.4	SECTION 162.920	162.920 Availability of implementation specifications and operating rules.
45:2.0.1.2.19.7.1.5	SECTION 162.923	162.923 Requirements for covered entities.
45:2.0.1.2.19.7.1.6	SECTION 162.925	162.925 Additional requirements for health plans.
45:2.0.1.2.19.7.1.7	SECTION 162.930	162.930 Additional rules for health care clearinghouses.
45:2.0.1.2.19.7.1.8	SECTION 162.940	162.940 Exceptions from standards to permit testing of proposed modifications.
45:2.0.1.2.19.8	SUBPART J	Subpart J - Code Sets
45:2.0.1.2.19.8.1.1	SECTION 162.1000	162.1000 General requirements.
45:2.0.1.2.19.8.1.2	SECTION 162.1002	162.1002 Medical data code sets.
45:2.0.1.2.19.8.1.3	SECTION 162.1011	162.1011 Valid code sets.
45:2.0.1.2.19.9	SUBPART K	Subpart K - Health Care Claims or Equivalent Encounter Information
45:2.0.1.2.19.9.1.1	SECTION 162.1101	162.1101 Health care claims or equivalent encounter information transaction.
45:2.0.1.2.19.9.1.2	SECTION 162.1102	162.1102 Standards for health care claims or equivalent encounter information transaction.
45:2.0.1.2.19.10	SUBPART L	Subpart L - Eligibility for a Health Plan
45:2.0.1.2.19.10.1.1	SECTION 162.1201	162.1201 Eligibility for a health plan transaction.
45:2.0.1.2.19.10.1.2	SECTION 162.1202	162.1202 Standards for eligibility for a health plan transaction.
45:2.0.1.2.19.10.1.3	SECTION 162.1203	162.1203 Operating rules for eligibility for a health plan transaction.
45:2.0.1.2.19.11	SUBPART M	Subpart M - Referral Certification and Authorization
45:2.0.1.2.19.11.1.1	SECTION 162.1301	162.1301 Referral certification and authorization transaction.
45:2.0.1.2.19.11.1.2	SECTION 162.1302	162.1302 Standards for referral certification and authorization transaction.
45:2.0.1.2.19.12	SUBPART N	Subpart N - Health Care Claim Status
45:2.0.1.2.19.12.1.1	SECTION 162.1401	162.1401 Health care claim status transaction.
45:2.0.1.2.19.12.1.2	SECTION 162.1402	162.1402 Standards for health care claim status transaction.
45:2.0.1.2.19.12.1.3	SECTION 162.1403	162.1403 Operating rules for health care claim status transaction.
45:2.0.1.2.19.13	SUBPART O	Subpart O - Enrollment and Disenrollment in a Health Plan
45:2.0.1.2.19.13.1.1	SECTION 162.1501	162.1501 Enrollment and disenrollment in a health plan transaction.
45:2.0.1.2.19.13.1.2	SECTION 162.1502	162.1502 Standards for enrollment and disenrollment in a health plan transaction.
45:2.0.1.2.19.14	SUBPART P	Subpart P - Health Care Electronic Funds Transfers (EFT) and Remittance Advice
45:2.0.1.2.19.14.1.1	SECTION 162.1601	162.1601 Health care electronic funds transfers (EFT) and remittance advice transaction.
45:2.0.1.2.19.14.1.2	SECTION 162.1602	162.1602 Standards for health care electronic funds transfers (EFT) and remittance advice transaction.
45:2.0.1.2.19.14.1.3	SECTION 162.1603	162.1603 Operating rules for health care electronic funds transfers (EFT) and remittance advice transaction.
45:2.0.1.2.19.15	SUBPART Q	Subpart Q - Health Plan Premium Payments
45:2.0.1.2.19.15.1.1	SECTION 162.1701	162.1701 Health plan premium payments transaction.
45:2.0.1.2.19.15.1.2	SECTION 162.1702	162.1702 Standards for health plan premium payments transaction.
45:2.0.1.2.19.16	SUBPART R	Subpart R - Coordination of Benefits
45:2.0.1.2.19.16.1.1	SECTION 162.1801	162.1801 Coordination of benefits transaction.
45:2.0.1.2.19.16.1.2	SECTION 162.1802	162.1802 Standards for coordination of benefits information transaction.
45:2.0.1.2.19.17	SUBPART S	Subpart S - Medicaid Pharmacy Subrogation
45:2.0.1.2.19.17.1.1	SECTION 162.1901	162.1901 Medicaid pharmacy subrogation transaction.
45:2.0.1.2.19.17.1.2	SECTION 162.1902	162.1902 Standard for Medicaid pharmacy subrogation transaction.