11 NCAC 23F .0103          Formats for Electronic Medical Bill Processing

(a)  Beginning March 1, 2014, electronic medical billing transactions shall be conducted using the electronic formats adopted under the Code of Federal Regulations, Title 45, part 162, subparts K, N, and P.  Whenever a standard format is replaced with a newer standard, the most recent standard shall be used.  The requirement to use a new version shall commence on the effective date of the new version as published in the Code of Federal Regulations.

(b)  Nothing in this Subchapter shall prohibit payers and health care providers from using a direct data entry methodology for complying with these requirements, provided the methodology complies with the data content requirements of the adopted formats and these Rules.


History Note:        Authority G.S. 97-26; 97-26(g1); 97-80;

Eff. January 1, 1996;

Recodified from 04 NCAC 10F .0102 Eff. July 1, 2014;

Amended Eff. July 1, 2014;

Recodified from 04 NCAC 10F .0103 Eff. June 1, 2018.