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Minnesota Department of Human Services MN–ITS User Manual
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MN–ITS User Manual

2014 – 2016 ARCHIVED Manual Revisions

Updates cited below do not include minor grammatical or formatting changes that otherwise do not have bearing on the meaning of the policy contained herein.

11/07/2016
Addition(s)/Revisions

837P Professional

  • HCBS Waiver, Alternative Care (AC), Moving Home Minnesota and Group Residential (GRH) Supplemental Services Claims – Removed information regarding EMA authorizations because it is no longer offered.
  • 10/19/2016
    Addition(s)/Revisions

    837P Professional

  • HCBS Waiver, Alternative Care (AC), Moving Home Minnesota and Group Residential (GRH) Supplemental Services Claims – Added Group Residential Housing (GRH) Supplemental Services to the Heading HCBS Waiver, Alternative Care (AC), Moving Home Minnesota.
  • 04/05/2016
    Addition(s)/Revisions

    837D Dental

  • Dental (837D) Claim Level COB - Billing for Dental Services – Corrected the Procedure Code Modifier(s) loops. Changed from SV101-3, SV101-4, SV101-5, & SV101-6 to SV301-3, SV301-4, SV301-5, & SV301-6.
  • Dental (837D) Line Level COB - Billing for Dental Services – Corrected the Procedure Code Modifier(s) loops. Changed from SV101-3, SV101-4, SV101-5, & SV101-6 to SV301-3, SV301-4, SV301-5, & SV301-6.
  • 12/29/2015
    Addition(s)/Revisions

    Other Applications

  • 1095-B File Instructions for Servicing Agencies – New section under Other Applications.
  • 12/07/2015
    Addition(s)/Revisions

    Home Care (Non-PCA) ServicesRemoved code G0154 for AC. Added the following two codes that will be used for AC G0299-Skilled Nurse (RN), Home Health 15 minute and G0300-Skilled Nurse (LPN), Home Health 15 minute.

    11/17/2015
    Addition(s)/Revisions

    Health Care Homes Help Screens

  • Health Care Homes Help – Batch Screen – Removed details about the Batch results and added a link to the Batch Results help screen for more information.
  • Health Care Homes Help — Data Entry Results Screen – Revised to remove statements that results display only for MHCP recipients. The tool can be used for any patient, whether they are enrolled with MHCP or not.
  • Health Care Homes Help – Data Entry Screen – Revised the diagnosis character length to reflect ICD-10 code changes. Added a link to the Data Entry Results help screen for more information.
  • 11/09/2015
    Addition(s)/Revisions

    837D Dental

  • Dental (837D) Claim Level COB - Billing for Dental Services – Updated the user guide to reflect the change in the diagnosis field to choose from the drop down menu if the ICD code is ICD-9 or ICD-10.
  • 10/30/2015
    Addition(s)/Revisions

    837I Institutional
    Updated the user guide to reflect the change in the diagnosis field to choose from the drop down menu if the ICD code is ICD-9 or ICD-10.

    837P Professional
    Updated the user guide to reflect the change in the diagnosis field to choose from the drop down menu if the ICD code is ICD-9 or ICD-10.

    10/28/2015
    Addition(s)/Revisions

    837P Professional
    Updated the user guide to reflect the change in the diagnosis field to choose from the drop down menu if the ICD code is ICD-9 or ICD-10.

    10/27/2015
    Addition(s)/Revisions

    837P Professional
    Updated the user guide to reflect the change in the diagnosis field to choose from the drop down menu if the ICD code is ICD-9 or ICD-10.

    10/05/2015
    Addition(s)/Revisions

    Health Care Homes Help Screens

  • Health Care Homes Help – Batch Results Screen – Removed references to ICD-9 references in the table descriptions.
  • Health Care Homes Help — Data Entry Results Screen – Removed ICD-9 code references under Pay-for Performance.
  • 10/01/2015
    Addition(s)/Revisions

    Health Care Homes Help Screens

  • Health Care Homes Help – Batch Screen – Removed references to ICD-9 references in the table descriptions.
  • 09/30/2015
    Addition(s)/Revisions

    837P Professional

  • Medicare Part A or Part B County Paid Premiums MN–ITS User Guide – Added ICD-10 information for billing.
  • 09/17/2015
    Addition(s)/Revisions

    837P Professional

  • 837P Billing for Special Transportation Services (STS) – Updated instructions to include drop down selection for ICD-9 or ICD-10.
  • 837I Institutional

  • 837I Inpatient Services – Added new Diagnosis Type field to indicate ICD-9 or ICD-10 diagnosis code.
  • 837I Outpatient Services – Added new Diagnosis Type field to indicate ICD-9 or ICD-10 diagnosis code.
  • 09/16/2015
    Addition(s)/Revisions

    837P Professional

  • 837P Basic Instructions Added new Diagnosis Type field to indicate ICD-9 or ICD-10 diagnosis codes. Added Supervising Provider to the Claim Information Screen.
  • 837P Billing for HIV Case Management – Added new Diagnosis Type field to indicate ICD-9 or ICD-10 diagnosis codes. Added Supervising Provider to the Claim Information Screen.
  • 08/19/2015
    Addition(s)/Revisions

    Direct Data Entry – Added Reverse to Copy, Replace and Void a Claim

  • Copy, Replace, Void, or Reverse a Claim – Added link to MN–ITS Request Claim Status (276/277) to Copy or Reverse a Claim
  • Use MN–ITS Request Claim Status (276/277) to Copy or Reverse a Claim – New
  • 06/11/2015
    Addition(s)/Revisions

    Direct Data Entry

  • Submit Direct Data Entry (DDE) Claims – Added link to EIDBI under 837P Professional
  • 837P Professional User Guides – Added link to EIDBI
  • Early Intensive Developmental Behavioral Intervention Claims (EIDBI) – Added a new guide for the Early Intensive Developmental Behavioral Intervention benefit effective July 1, 2015.
  • 05/11/2015
    Addition(s)/Revisions

    MN–ITS Administration

  • Modify or Change Your MN–ITS Password – Clarified that this symbol does not work for MN–ITS strong passwords: &
  • 04/20/2015
    Addition(s)/Revisions

    MN–ITS Administration
    Modify or Change Your MN–ITS Password
    – Clarified that these symbols do not work for MN–ITS strong passwords: “ ‘ < >

    04/08/2015
    Addition(s)/Revisions

    Direct Data Entry
    Use MN–ITS 837 Claims Submit Response to Copy, Void or Replace a Claim
    – Removed references to defaulted fields. When you copy, replace or void a claim directly from the submission response, all data is returned as it was submitted on the claim.

    04/07/2015
    Addition(s)/Revisions

    Direct Data Entry
    Use MN–ITS Request Claim Status (276/277) to Copy, Void or Replace a Claim
    – Revised information in the table of defaulted fields for Ambulance information and line level Ordering and Referring providers:

  • • For claims submitted prior to March 15, 2015, these fields will be returned blank.
  • • For claims submitted on or after March 15, 2015, these fields will be returned as they were submitted on the claim.
  • 04/03/2015
    Addition(s)/Revisions

    Direct Data Entry
    Submit Direct Data Entry (DDE) Claims

    Pharmacy (NCPDP) Instructions – Added information on how to add more than one diagnosis code and also gave instructions on how to add claim/reversal option for users in MN–ITS in order to reverse claims.

    03/19/2015
    Addition(s)/Revisions

    837I Outpatient Services for Rehabilitative Services, OT, PT and SLP – Other Providers, Referring Providers, (Loop: 2420D, NM109);
    Any Provider listed here will override at header level.

  • • From the Other Providers accordion select Referring Provider
  • • Enter NPI of the provider who is not already reported at claim level as the Attending Provider or the Referring provider.
  • • When reporting the NPI use the recipient for the service associated with that line
  • • Select the Add action button in this section to add the provider information
  • • Select the radio button to add the provider to the claim
  • 837I Outpatient Services – Other Providers, Referring Provider, (Loop: 2420D, NM109);
    Any Provider listed here will override at header level.

  • • From the Other Providers accordion select Referring Provider
  • • Enter NPI of the provider who is not already reported at claim level as the Attending Provider or the Referring provider.
  • • When reporting the NPI use the recipient for the service associated with that line
  • • Select the Add action button in this section to add the provider information
  • • Select the radio button to add the provider to the claim
  • 837I Outpatient Chemical Dependency (CD) Services – Other Providers, Referring Provider, (Loop: 2420D, NM109);
    Any Provider listed here will override at header level.

  • • From the Other Providers accordion select Referring Provider
  • • Enter NPI of the provider who is not already reported at claim level as the Attending Provider or the Referring provider.
  • • When reporting the NPI use the recipient for the service associated with that line
  • • Select the Add action button in this section to add the provider information
  • • Select the radio button to add the provider to the claim
  • 837P Billing for Child and Teen Checkups (C&TC) Services – Added the accordion for the ambulance services in the claims services screen. Added the accordion for the ambulance services to the services lines and added the supervising provider to the services lines other provider section.

    837P Billing for Hearing Aid Services – Added the accordion for the ambulance services in the claims services screen. Added the accordion for the ambulance services to the services lines and added the supervising provider to the services lines other provider section.

    837P Federally Qualified Health Center and Rural Health Clinic (FQHC/RHC) Services – Added the accordion for the ambulance services in the claims services screen. Added the accordion for the ambulance services to the services lines and added the supervising provider to the services lines other provider section.

    837P Billing for Durable Medical Equipment, Medical Supplies, Prosthetics and Orthotics, and Augmentative Devices – Added the accordion for the ambulance services in the claims services screen. Added the accordion for the ambulance services to the services lines and added the supervising provider to the services lines other provider section.

    837P Billing for Certified Registered Nurse Anesthetist (CRNA) – Added the accordion for the ambulance services in the claims services screen. Added the accordion for the ambulance services to the services lines and added the supervising provider to the services lines other provider section.

    837P Billing for HIV Case Management – Added the accordion for the ambulance services in the claims services screen. Added the accordion for the ambulance services to the services lines and added the supervising provider to the services lines other provider section.

    837P Billing for IEP Services – Added the accordion for the ambulance services in the claims services screen. Added the accordion for the ambulance services to the services lines and added the supervising provider to the services lines other provider section.

    837P Billing for Medication Therapy Management Service – Added the accordion for the ambulance services in the claims services screen. Added the accordion for the ambulance services to the services lines and added the supervising provider to the services lines other provider section.

    837P Billing for Mental Health Targeted Case Management (MH-TCM) – Added the accordion for the ambulance services in the claims services screen. Added the accordion for the ambulance services to the services lines and added the supervising provider to the services lines other provider section.

    837P Rehabilitative Services, OT, PT and SLP – Added the accordion for the ambulance services in the claims services screen. Added the accordion for the ambulance services to the services lines and added the supervising provider to the services lines other provider section.

    03/18/2015
    Addition(s)/Revisions

    837I Inpatient Services – Other Providers, Referring Provider, (Loop: 2420D, NM109);
    Any Provider listed here will override at header level.

  • • From the Other Providers accordion select Referring Provider
  • • Enter NPI of the provider who is not already reported at claim level as the Attending Provider or the Referring provider.
  • When reporting the NPI use the recipient for the service associated with that line

  • • Select the Add action button in this section to add the provider information
  • • Select the radio button to add the provider to the claim
  • 837I Outpatient Ambulance Services – Changed Data Expansion Fields.

    837I Long Term Care Services – Changed Data Expansion Fields.

    837I Hospice Services – Changed Data Expansion Fields.

    03/17/2015
    Addition(s)/Revisions

    837I Inpatient Chemical Dependency (CD) Services – Other Providers; Referring Provider; (Loop: 2420D, NM109);
    Any Provider listed here will override at header level.

  • • From the Other Providers accordion select Referring Provider
  • • Enter NPI of the provider who is not already reported at claim level as the Attending Provider or the Referring provider.
  • When reporting the NPI use the recipient for the service associated with that line

  • • Select the Add action button in this section to add the provider information
  • • Select the radio button to add the provider to the claim
  • 03/16/2015
    Addition(s)/Revisions

    837I Home Care (Non-PCA) Services – Other Providers; Referring Provider; (Loop: 2420D, NM109);
    Any Provider listed here will override at header level.

  • • From the Other Providers accordion select Referring Provider
  • • Enter NPI of the provider who is not already reported at claim level as the Attending Provider or the Referring provider.
  • When reporting the NPI use the recipient for the service associated with that line

  • • Select the Add action button in this section to add the provider information
  • • Select the radio button to add the provider to the claim
  • 837P Ambulance Services – Updated the Ambulance Services 837P user guide with the ambulance fields on the claims information screen and the services screen at the line level.

    837P Basic Instructions – Updated the Ambulance Services 837P user guide with the ambulance fields on the claims information screen and the services screen at the line level.

    837P Special Transportation Services (STS) – Updated the user guide with the data expansion fields on the ambulance accordion screens at the claim level and also line level also added the supervisor provider accordion to the line level.

    01/21/2015
    Addition(s)/Revisions

    837P Professional User Guides – Added Moving Home Minnesota to Waiver, Alternative Care.

    Submit Direct Data Entry (DDE) Claims – Added Moving Home Minnesota to Waiver, Alternative Care.

    01/15/2015
    Addition(s)/Revisions

    HCBS Waiver and Alternative Care (AC) Claims – Added Moving Home Minnesota to 837P Waiver/AC Claims.

    ***********************************************************

    2014 Revisions

    12/08/2014
    Addition(s)/Revisions

    Other Applications – Added links to Death Data Match Create/Modify/Assign MN–ITS User Access and Death Data Match User Guide.

    07/11/2014
    Addition(s)/Revisions

    Professional (837P) - Billing for IEP Services – Added text to COB and Situational.

    06/11/2014
    Addition(s)/Revisions

    MHCP MN–ITS 837I Institutional User Guides – Added a link to the New MN–ITS DDE Screens 837I document.

    05/23/2014
    Addition(s)/Revisions

    837P HCBS Waiver and Alternative Care (AC) Claims – Added Service line note and description fields.

    04/30/2014
    Addition(s)/Revisions

    837P HCBS Waiver and Alternative Care (AC) Claims – Added link to Waiver and AC Programs – Specialized Supplies & Equipment Authorization & Billing Responsibilities section.

    01/14/2014
    Addition(s)/Revisions

    277 Claims Submit Response to Copy, Void or Replace a Claim – Clarified the wording from radio button to Type of Claim field on both the void and replacement sections of the user guide and changed replacement to void in the void section.

    01/13/2014
    Addition(s)/Revisions

    Rehabilitative Services, OT, PT and SLP – Updated Rendering Provider information.

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