Medicare Secondary Payer (MSP) Manual
Chapter 6 - Medicare Secondary Payer (MSP)
Common Working File (CWF) Process
Table of Contents
(Rev. 12078; Issued: 06-14-23)
Transmittals for Chapter 6
10 - General Information
10.1 - Overview of CWF, MSP Processing
10.2 - Definition of MSP/CWF Terms
20 - MSP Maintenance Transaction Record Processing
20.1 - Types of MSP Maintenance Transactions
20.1.1 - MSP Add Transaction
20.1.2 - MSP Change Transaction
20.1.3 - MSP Delete Transaction
20.1.4 - MSP Termination Date Transaction
20.2 - MSP Maintenance Transaction Record A/B MAC and DME MAC MSP
Auxiliary File Update Responsibility
30 - CWF, MSP Auxiliary File
30.1 - Integrity of MSP Data
30.1.1 - MSP Effective Date Change Procedure
30.1.2 - CWF/MSP Transaction Request for Contractor Assistance
30.2 - MSP Termination Date Procedure
30.3 - MSP Auxiliary File Errors
30.3.1 - Valid MSP Remarks Codes
30.3.2 - Valid MSP Insurance Type Codes
30.3.3 - Other Effective Date and Termination Date Coverage Edits
30.3.4 - MSP Employee Information Data Code
30.4 - Automatic Notice of Change to MSP Auxiliary File
40 - MSP Claim Processing
40.1 - CWF, MSP Claim Validation
40.2 - CWF Claim Matching Criteria Against MSP Records
40.3 - Conditional Payment
40.4 - Override Codes
40.5 - MSP Cost Avoided Claims
40.6 - Online Inquiry to MSP Data
40.7 - MSP Purge Process
40.8 - MSP Utilization Edits and Resolution for Claims Submitted to CWF
40.9 - CWF MSP Reject for A Beneficiary Entitled to Medicare Part B Only and
A GHP
40.10 – ICD-10 and ICD 9-CM Diagnosis Code Tables Involving Non-GHP MSP
Claims
40.10.1 - Certain Diagnosis Codes Not Allowed on NGHP MSP Records
50 - Special CWF Processes
50.1 - Extension of MSP-ESRD Coordination Period
50.2 - MSP “W” Records and Accompanying Processes
60 – Converting Health Insurance Portability and Accountability Act (HIPAA) Individual
Relationship Codes to Common Working File (CWF) Medicare Secondary Payer
(MSP) Patient Relationship Codes
10 - General Information
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
A/B Medicare Administrative Contractors (MACs) (Part A), A/B MACs (Part B), or A/B
MACs (Part HHH) (collectively referred to as A/B MACs) and Durable Medical
Equipment MACs (DME MACs) obtain information pertinent to the identification of MSP
for each beneficiary via the CWF, MSP auxiliary file. The auxiliary file is associated with
the beneficiary's master record within CWF.
The MSP Contractor completes MSP updates on a daily basis upon receipt of notice that
another payer is primary to Medicare (e.g., an explanation of benefits, a beneficiary
questionnaire, a notice from a third-party payer, Section 111 reporting, etc.). Every claim
for a given beneficiary is validated against the same MSP data housed in a CWF, MSP
auxiliary file, thus permitting uniform processing. Contractor claims data inconsistent
with a CWF, MSP auxiliary file will cause rejects and/or error conditions. An MSP
auxiliary record consistent with an identified MSP situation must be present before a
payment is approved for an MSP claim. An MSP auxiliary record is established by an
MSP maintenance transaction submitted to CWF. The claim must agree with the MSP
auxiliary record that was established, or it will not process.
The MSP Contractor is the source for establishing new MSP records, with the exception
of four situations described in §10.1, below. The MSP Contractor submits MSP
maintenance transactions on the basis of information obtained outside the claims process.
Examples include, voluntary MSP insurer data match agreements, MMSEA Section 111
reporting, attorney, beneficiary, provider information, and 411.25 Notices.
10.1 - Overview of CWF MSP Processing
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
The CWF MSP auxiliary file is updated with maintenance transactions from the MSP
contractor responsible for coordination of benefits (formerly known as the Benefits
Coordination & Recovery Center or Coordination of Benefits Contractor and hereafter
termed the “MSP contractor”), except for the following situations:
1. If the A/B Medicare Administrative Contractor (MAC) (Part A), A/B MAC
(Part B), or A/B MAC (HHH) (collectively referred to as A/B MACs) or Durable
Medical Equipment Medicare Administrative Contractor (DME MAC) receives a phone
call or correspondence from an attorney/other beneficiary representative, beneficiary,
third-party payer, provider, another insurer’s Explanation of Benefits (EOB) or other
source that establishes, exclusive of any further required development or investigation,
that MSP no longer applies, it must add termination dates to MSP auxiliary records
already established by the MSP contractor with a "Y" validity indicator where there is no
discrepancy in the validity of the information contained on CWF. (See §20.1.4)
2. If the A/B MAC receives a claim for secondary benefits and could, without
further development (for example, the EOB from another insurer or third-party payer
contains all necessary data) add an MSP occurrence and pay the secondary claim, it
submits a validity indicator of "I" to add any new MSP occurrences (only if no MSP
record with the same MSP type already exists on CWF with an effective date within 45
days of the effective date of the incoming "I" record). An “I” record is to be added to the
CWF within 10 calendar days when the claim is suspended for MSP (internal system or
CWF, whichever suspends first) if no MSP record with the same MSP type already exists
in CWF. It cannot submit a new record with a "Y" or any record with an "N" validity
indicator. Note: Effective October 1, 2021, DME MACs no longer submit “I” records
and instead submit an Electronic Correspondence Referral System (ECRS) Inquiry to
create an MSP record.
3. If the A/B MAC receives a claim for conditional payment, and the claim
contains sufficient information to create an "I" record without further development, it
must add the MSP occurrence using an "I" validity indicator (only if no MSP record with
the same MSP type already exists on CWF with an effective date within 45 calendar days
of the effective date of the incoming "I" record). An “I” record is to be added to the CWF
within 10 calendar days when the claim is suspended for MSP (internal system or CWF,
whichever suspends first) if no MSP record with the same MSP type already exists in
CWF.
A/B MACs shall transmit "I" records to CWF via the current HUSP transaction. The
CWF will treat the "I" validity indicator the same as a "Y" validity indicator when
processing claims. "I" records should only be submitted to CWF if no MSP record with
the same MSP type already exists on CWF with an effective date within 45 days of the
effective date of the incoming "I" record. Therefore, "I" records submitted to CWF that
fail these edit criteria will be rejected with an SP 20 error code. Receipt of an "I" validity
indicator will result in a CWF trigger to the MSP contractor. The MSP contractor will
develop and confirm all "I" maintenance transactions established by the A/B MAC. If
the MSP contractor receives an affirmative confirmation of MSP through its development
efforts within 45 calendar days, the MSP contractor will convert the “I” to a “Y” validity
indicator. If the MSP contractor has not received confirmation of MSP through its
development efforts within 45 calendar days, the MSP contractor will automatically
delete the "I" validity indicator. Also, if the MSP contractor develops and determines
there is no MSP, the MSP contractor will delete the "I" record. An "I" record should
never be established when the mandatory fields of information are not readily available to
the A/B MAC on its claim attachment or unsolicited refund documentation. If the A/B
MAC has the actual date that Medicare became secondary payer, it shall use that as the
MSP effective date. If that information is not available, it shall use the Part A entitlement
date as the MSP effective date. It may include a termination date when it initially
establishes an "I" record. It may not add a termination date to an already established "I"
record.
Prior to April 1, 2002, the A/B MACs and DME MACs posted MSP records to CWF
where beneficiaries were entitled to Part B benefits, but not entitled to Part A benefits.
An MSP situation cannot exist when a beneficiary has GHP coverage (i.e., working aged,
disability and ESRD) and is entitled to Part B only. CWF edits to prevent the posting of
these MSP records to CWF when there is no Part A entitlement date. If an A/B MAC or
DME MAC submits an Electronic Correspondence Referral System (ECRS) transaction
to the MSP contractor to add a GHP MSP record where there is no Part A entitlement, the
MSP contractor will return reason code of 61. A/B MACs or DME MACs should not
submit an ECRS request to the MSP contractor to establish a GHP MSP record when
there is no Part A entitlement. A/B MACs that attempt to establish an "I" record will
receive a CWF error.
The CWF will continue to allow the posting of MSP records where there is no Part A
entitlement, but there is Part B entitlement, and where NGHP situations exist, such as
automobile/No-Fault, liability, and workers' compensation. Where a non-employer GHP
situation exists, A/B MACs and DME MACs continue to submit ECRS transactions and
establish "I" records, as necessary. Note: In the past A/B MACs and DME MACs have
sent ECRS requests to the MSP contractor requesting that section 111 records be updated.
The MSP contractor has rejected most of these requests based on CMS hierarchy of
Section 111 entities taking precedence on updating contractor number 11121 and 11122
MSP records. However, CMS has clarified that the MSP contractor shall accept MACs
ECRS requests to update contractor number 11121 and 11122 MSP records based on
conditions below. A/B MACs and DME MACs shall continue to submit ECRS requests
to the MSP contractor for contractor numbers 11121 and 11122 for the following
circumstances:
• When the A/B MAC or DME MAC receives information indicating the Group
number or policy number of the primary payer has changed,
• When the A/B MAC or DME MAC learns of a retirement date for the beneficiary
and a termination date must be added to the MSP record,
• When the A/B MAC or DME MAC receives information indicating the Insurance
Type A, J, or K has changed or conflicts with what is on the CWF MSP Auxiliary
file, or
• When an A/B MAC or DME MAC receives a primary payer EOB or remittance
advice showing payment for a deleted or closed Section 111 GHP MSP record
that should remain open. Note: The MSP Contractor will not accept an NGHP
record update request for this type of MSP claim situation.
Please note it is to the discretion of the MSP Contractor to approve these Section 111
ECRS requests upon review. Approval or denial of such ECRS requests shall be sent to
the A/B MACs or DME MACs by the MSP Contractor.
MSP Auxiliary maintenance transactions, for the four situations listed above, and claims
for payment approval may be submitted to CWF in the same file. The CWF processes the
MSP maintenance transactions before processing claims. This procedural flow is to
assure processing for claim validation against the most current MSP data. If the MSP
claim is accepted, the CWF host will return all MSP data on a beneficiary's auxiliary file
to the submitting contractor via an "03" trailer. If the claim is rejected, the host will return
only those MSP records that fall within the dates of service on the claim. A maximum of
17 MSP auxiliary records may be stored in CWF for each beneficiary (see §30 below).
The validity indicator field of each CWF MSP auxiliary record indicates confirmation
that:
Another insurer is responsible for payment ("Y" in the field); A/B MACs and DME
MACs may access the MSP auxiliary file through the online CWF file display utility
Health Insurance Master Record (HIMR).
A/B MACs and DME MACs cannot delete MSP auxiliary records. They send such
requests to the MSP contractor via ECRS. (See Pub. 100-05, Chapter 5, §10.)
10.2 - Definition of MSP/CWF Terms
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
Following is a list of terms and their definitions used in MSP/CWF processing.
MSP Auxiliary File - Up to 17 beneficiary MSP occurrences/records on the CWF
database.
MSP Auxiliary Record - Record of beneficiary MSP information. One MSP
record/occurrence within the beneficiary's MSP auxiliary file.
Occurrence - One MSP occurrence/record within the beneficiary's MSP auxiliary file.
MSP Effective Date - Effective date of MSP coverage.
MSP Termination Date - Termination date of MSP coverage.
Validity Indicator
• Y - Beneficiary has MSP coverage (there is a primary insurer for this period of
time).
• N - No MSP coverage (the N validity indicator is no longer used, but will be seen
on older MSP CWF records)
• I - See §10.1.
• D – Deleted MSP Record
MSP Types - Reason for other coverage entitlement.
• A = Working Aged
• B = End stage renal disease (ESRD)
• D = Automobile/Liability No-Fault
• E = Workers' Compensation (WC)
• F = Federal, Public Health (note: currently not used)
• G = Disabled
• H = Black Lung (BL)
• L=Liability
• W=Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA)
NOTE: VA and other Federal payments are MSP exclusions rather than MSP non-
payments. Where the VA authorized services, Medicare does not make payment for items
or services furnished by a non-Federal provider pursuant to such an authorization.
Although certain MSP billing procedures apply, VA is not an MSP provision.
Cost Avoided Claim - A claim returned without payment because CWF indicators
indicate another insurer is primary to Medicare. (See Pub. 100-05, Chapter 5 for
complete description.)
Transaction Type - Identifies type of maintenance record.
• 0 = Transaction type to add or change MSP data
• 1 = Transaction type to delete MSP data
Override Code - Code used to bypass CWF, MSP edit to allow primary Medicare
payment. (See §40.4 for a detailed explanation.)
MSP Contractor Numbers
CWF
Source
Codes
MSP Contractor Numbers
Non-
payment/
Payment
Denial Codes
CROWD Special
Project Numbers
33333 = Litigation Settlement
V
4000
P
55555 = HMO Rate Cell
Adjustment
U
3000
B,D,T,U,V,
or W
77777 = IRS/SSA/HCFA Data
Match (I, II, III, IV, V, or VI)
Y
1000
Q
88888 = Voluntary Data Sharing
Agreements
Q
5000
O
99999 = Initial Enrollment
Questionnaire
T
2000
MSP Contractor Numbers prior to January 1, 2001
CWF
Source
Codes
MSP Contractor Numbers
Non-
payment/
Payment
Denial Codes
CROWD Special
Project Numbers
0
11100 = MSP Contractor
6000
1
11101 = Initial Enrollment
Questionnaire
K
6010
2
11102 = IRS/SSA/CMS Data
Match
E
6020
3
11103 = HMO Rate Cell
F
6030
CWF
Source
Codes
MSP Contractor Numbers
Non-
payment/
Payment
Denial Codes
CROWD Special
Project Numbers
4
11104 = Litigation Settlement
G
6040
5
11105 = Employer Voluntary
Reporting
H
6050
6
11106 = Insurer Voluntary
Reporting
H
6060
7
11107 = First Claim
Development
E
6070
8
11108 = Trauma Code
Development
F
6080
9
11109 = Secondary Claims
Investigation
G
6090
X
11110 = Self Reports
H
7000
Y
11111 = 411.25
J
7010
NOTE: Effective January 1, 2001, the following MSP Contractor numbers and
nonpayment/payment denial codes will be used.
MSP Contractor Numbers Effective January 1, 2001
CWF
Source
Codes
Non-
payment/
Payment
Denial Codes
CROWD Special
Project Numbers
0
00 Effective
4/1/2020
6000
1
T
6010
2
Y
6020
3
U
6030
4
V
6040
5
Q
6050
6
K
6060
7
E
6070
8
F
6080
CWF
Source
Codes
Non-
payment/
Payment
Denial Codes
CROWD Special
Project Numbers
9
G
6090
10 -
Effective
4/1/2002
H
7000
11 -
Effective
4/1/2002
J
7010
11101, 11102, 11103, 11104, and 11105 use the same non-payment denial codes as
their previous contractor numbers (i.e., 33333, 55555, 77777, 88888, 99999). Savings
from the old and new numbers, if applicable will be reported together (e.g., 11101
and 99999, etc). There must be a conversion of the MSP savings to the new non-
payment/payment denial codes as of January 1, 2001.
Additional MSP Contractor Numbers Effective April 1, 2002
Effective April 1, 2002, CWF is expanding the source code field and the
nonpayment/ payment denial code field from 1-position fields to 2-position fields.
CWF
Source
Codes
MSP Contractor Numbers
Non-
payment/
Payment
Denial Codes
CROWD Special
Project Numbers
12
11112 = Blue Cross-Blue Shield
Voluntary Data Sharing
Agreements
12
7012
13
11113 = Office of Personnel
Management (OPM) Data Match
13
7013
14
11114 = State Workers'
Compensation (WC) Data Match
14
7014
15
11115 = WC Insurer Voluntary
Data Sharing Agreements (WC
VDSA)
15
7015
16
11116 = Liability Insurer
Voluntary Data Sharing
Agreements (LIAB VDSA)
16
7016
17
11117 = Voluntary Data Sharing
Agreements (No Fault VDSA)
17
7017
CWF
Source
Codes
MSP Contractor Numbers
Non-
payment/
Payment
Denial Codes
CROWD Special
Project Numbers
18
11118 = Pharmacy Benefit
Manager Data
18
7018
19
11119 = Workers’ Compensation
Medicare Set-Aside Arrangement
19
7019
20
11120 = COBA
20
N/A
21
11121= MIR Group Health Plan
21
7021
22
11122= MIR Non-Group Health
Plan
22
7022
23
11123 = To be determined
23
7023
24
11124 = To be determined
24
7024
25
11125 = Recovery Audit
Contractor-California
25
7025
26
11126 = Recovery Audit
Contractor-Florida
26
7026
27
11127 = To be determined
27
7027
“”
“”
“”
“”
39
11139 = GHP Recovery
39
7039
41
11141 =NGHP Non Ongoing
Responsibility for Medicals
(ORM)
41
7041
42
11142 = NGHP ORM Recovery
42
7042
43
11143 = MSP Contractor
/Medicare Part C/Medicare
Advantage
43
7043
“”
“”
“”
“”
99
11199 = To be determined
99
7099
20 - MSP Maintenance Transaction Record Processing
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
The MSP Contractor shall submit an MSP maintenance transaction to establish an MSP
auxiliary record within 10 calendar days of receipt of notice that another payer is primary
to Medicare. The CWF applies extensive editing to the maintenance transaction. If an
MSP maintenance transaction does not meet all edit criteria, error codes specific to the
failed edit(s) will be returned via the CWF MSP Maintenance Transaction Response. A
complete record layout and field descriptions are contained in CWF Systems
Documentation, Record Name: CWF, MSP Maintenance Transaction Response. For Out-
of-Service (OSA) Area transactions, the CWF OSA Maintenance Transaction Response is
used. Its complete record layout and field descriptions are contained in CWF Systems
Documentation, Record Name: CWF, MSP Maintenance Transaction Response. The
consistency edit error codes and edit definitions are contained in CWF Systems
Documentation Record Name: MSP Maintenance Transaction Error Codes. MSP
transactions that pass all edits are applied to the CWF, MSP auxiliary file.
20.1 - Types of MSP Maintenance Transactions
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
The three types of maintenance transactions are add, change, and delete.
The MSP Contractor shall use MSP maintenance transaction type "O" (zero) for an add
or a change transaction.
• The transaction is an add when no matching MSP occurrence - NO MATCHING
MSP auxiliary record - is found for the beneficiary;
• The transaction is a change when a matching MSP occurrence is found.
After a successful MSP maintenance transaction processes through CWF, before and
after images of the MSP auxiliary file occurrence are written to the MSP Audit File.
20.1.1 - MSP Add Transaction
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
The two situations in which the "add" maintenance transaction is used are:
• There is no MSP auxiliary file record for a beneficiary. In this case, the "add"
transaction creates an MSP auxiliary record containing the new MSP transaction
and sets the MSP indicator on the beneficiary's master record; or
• There is an MSP auxiliary file record but no matching occurrence for the
beneficiary. In this case, the "add" transaction adds the maintenance transaction as
a new occurrence.
The following fields are mandatory for a validity indicator of "Y" or "I" (Another insurer
is responsible for payment):
• Medicare beneficiary identifier;
• MSP type (MSP code);
• Validity indicator;
• MSP effective date;
• Contractor identification number;
• Insurer name (CWF will allow a space in the second position provided the third
position contains a valid character other than a space.);
• Patient relationship; and
• Insurance type.
A "Y" or "I" record CANNOT be established without the insurer name. Note, if the
Insurance Company Name is blank, or contains one of the abbreviated values that should
not be used as found in the ECRS manual, then it is considered an error.
NOTE: Although the insurer address cannot be MANDATORY, it should be provided
whenever possible.
The following are to be used as default values when creating an “I” record:
(1) MSP Effective Date: Use the Part A entitlement date.
(2) Patient Relationship: Use “01” if there is no indication of other insured member, and
use “02” if another member is shown, but uncertain of relationship.
(3) MSP Type: For GHP, use the current reason for entitlement: working aged (12),
disability (43), or ESRD (13). For NGHP, if not identified, the default to be used is No-
Fault (14).
20.1.2 - MSP Change Transaction
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
An MSP change transaction occurs when the key fields on the incoming maintenance
transaction match those on an existing MSP auxiliary occurrence.
An MSP record match occurs when the following items are the same:
Medicare beneficiary identifier;
MSP type;
MSP effective date;
Insurance type; and
Patient relationship
When these items match, the record is overlaid.
No change transactions will be permitted to records established, except for the addition of
a termination date, by any contractor other than the MSP Contractor.
20.1.3 - MSP Delete Transaction
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
The MSP maintenance type "1" is used to delete an MSP auxiliary occurrence. This
transaction checks the beneficiary's master record for an MSP indicator. The MSP
Contractor is responsible for submitting this transaction. A/B MACs and DME MACs
advise the MSP Contractor, via the ECRS, of the need to process an MSP maintenance
type 1 transaction (delete).
Only certain MSP contractor numbers may delete MSP occurrences originated or last
updated by certain other MSP contractor numbers. No contractor number may update or
delete a MSP occurrence originated or last updated by contractor number 11100 except
contractor number 11100. Please see the table below for the exact criteria for deletion of
MSP occurrences last updated by MSP contractor numbers. A match shall occur in order
to delete the MSP occurrence originated or last updated by one MSP contractor number
with a delete transaction submitted under a certain MSP contractor number. For example,
MSP contractor numbers 11100, 11110, 11141 and 11140 are the only contractor
numbers that may delete a MSP occurrence originated or last updated by 11110. The
MSP Contractor is the sole contractor that may delete MSP contractor numbers. The MSP
Contractor shall maintain the necessary logic to control updating and deleting MSP
occurrences based on MSP contractor numbers. A/B MACs and DME MACs shall follow
the current restrictions regarding deletion of MSP records.
Originating
or Last
Updating
Contractor
Number
MSP Contractor Number That Can Update/Delete
11100
11100
11110
11100, 11110, 11139, 11141, 11140, 11142
11141
11100, 11110, 11139, 11141, 11140, 11142
11140
11100, 11110, 11139, 11141, 11140, 11142
11121
11100, 11110, 11141, 11140, 11121, 11143, 11139, 11142
11122
11100, 11110, 11141, 11140, 11121, 11143, 11139, 11142
11143
11100, 11110, 11141, 11140, 11121, 11143, 11139, 11142
11139
11100, 11110, 11141, 11140, 11121, 11143, 11139, 11142
11142
11100, 11110, 11141, 11140, 11121, 11143, 11139, 11142
11105
11100, 11110, 11141, 11140, 11121, 11143, 11105, 11102, 11139,
11142
11102
11100, 11110, 11141, 11140, 11121, 11143, 11105, 11102, 11139,
11142
All others
Any
The MSP Contractor shall allow (MMSEA Section 111) GHP responsible reporting
entities (RREs) to override this update/delete hierarchy reflected in the table above under
certain circumstances. MIR GHP RREs must submit an override code to the MSP
Contractor after receiving an error on an attempted update/delete. The MSP Contractor
applies the update/delete using contractor number 11121. This override capability shall
not apply to MSP occurrences originated or last updated by 11100.
The MSP Contractor shall apply the same hierarchy rules represented in the table above
to transactions that have the effect of adding back or reopening matching MSP
occurrences previously deleted.
20.1.4 - MSP Termination Date Transaction
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
A/B MACs and DME MACs add termination dates to MSP auxiliary records already
established on CWF with a "Y" validity indicator, where there is no discrepancy in the
validity of the information contained on CWF. They handle phone calls and written
inquiries relating to simple terminations of existing MSP occurrences. Simple
terminations are defined as terminations that can be made to an MSP auxiliary record
without further development or investigation. They shall not transfer these calls or
written inquiries to the MSP Contractor. In determining whether a call is to be handled
by them or the MSP Contractor, the A/B MAC or DME MAC establishes the basis of the
call. The following are examples when not to transfer a termination request to the MSP
Contractor for further action.
EXAMPLE 1:
Scenario: Mr. Doe is calling to report that his employer group health coverage has
ended.
A/B MACs and DME MAC action: The A/B MACs and DME MACs checks for
matching auxiliary record on CWF and terminates, if no conflicting data are presented.
The A/B MACs and DME MACs does not transfer the call to the MSP Contractor.
EXAMPLE 2:
Scenario: Mrs. X is calling to report that she has retired.
A/B MACs and DME MACs action: The A/B MACs and DME MACs checks for
matching auxiliary record on CWF and terminates if no conflicting data are presented.
The A/B MACs and DME MACs does not transfer the call to the MSP Contractor.
EXAMPLE 3:
Scenario: The A/B MACs or DME MACs receives written correspondence that benefits
are exhausted for an automobile case.
A/B MACs and DME MACs action: The A/B MAC and DME MAC checks for matching
auxiliary record on CWF. The MSP Contractor terminates in accordance with existing
guidelines (e.g., accounting of monies spent).
EXAMPLE 4
Scenario: Union Hospital is calling to report that the MSP period contained on CWF for
beneficiary X should be terminated.
A/B MAC and DME MAC action: The A/B MAC and DME MAC checks for matching
auxiliary record on CWF and terminates if no conflict in evidence is presented. It does
not transfer the call to the MSP Contractor.
MSP Contractor Role
The MSP Contractor adds termination dates to records not covered in A, above. In
addition, the MSP Contractor updates MSP occurrences as a result of a request from an
A/B MAC or DME MAC, or as a result of the MSP Contractor development and
investigation. The following are examples of when to transfer a termination request to the
MSP Contractor for further action.
EXAMPLE 1:
Scenario: The termination date is greater than six months prior to the date of accretion
(i.e., SP 57 error code) for all MSP Contractor numbers (e.g., 11100-11145, 33333,
77777, 88888, or 99999). (All MSP Contractor numbers follow the old data match 6-
month termination rule.)
A/B MAC and DME MAC action: The A/B MAC and DME MAC sends a CWF
assistance request to the MSP Contractor.
MSP Contractor action: The MSP Contractor checks for matching record on CWF and
terminates. In cases where discrepant information exists, the MSP Contractor investigates
to determine the proper course of action.
EXAMPLE 2:
Scenario: The A/B MAC and DME MAC receives information with regard to
termination that is discrepant with the information contained on CWF.
A/B MAC and DME MAC action: The A/B MAC and DME MAC forwards to the MSP
Contractor for investigation via ECRS.
MSP Contractor action: The MSP Contractor checks for matching record on CWF,
investigates, and terminates if appropriate.
20.2 - MSP Maintenance Transaction Record A/B MAC and DME MAC
MSP Auxiliary File Update Responsibility
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
The capability to update the CWF MSP auxiliary file is essentially a function of only the
MSP Contractor. The A/B MAC and DME MACs do not have the capability to delete
any MSP auxiliary file records, including those that a specific A/B MAC or DME MAC
established. If it is believed that a record should be changed or deleted, A/B MACs and
DME MACs use the MSP Contractor via the ECRS (discussed in Pub. 100-05, Chapter 5,
CWF Assistance Request option, to notify the MSP Contractor of the needed revision.
A/B MACs and DME MACs process claims in accordance with existing claims
processing guidelines.
There are only two instances in which A/B MACs and DME MACs retain the capability
to update CWF. They are:
A. A claim is received for secondary benefits and the contractor could, without further
development (for example, the EOB from another insurer or third-party payer contains all
necessary data), add an MSP occurrence and pay the secondary claim. A/B MACs must
use a validity indicator of "I" to add new MSP occurrences and update CWF. An “I”
record is to be added to the CWF within 10 calendar days when the claim is suspended
for MSP (internal system or CWF, whichever suspends first) if no MSP record with the
same MSP type already exists in CWF. Note: Effective October 1, 2021, DME MACs no
longer submit“I”records and instead submit an Electronic Correspondence Referral
System (ECRS) Inquiry to create an MSP record. A/B MACs cannot submit a new record
with a "Y" or any record with an "N" validity indicator.
B. A claim is received for conditional payment, and the claim contains sufficient
information to create an "I" record without further development. A/B MACs add the MSP
occurrence using an "I" validity indicator. An “I” record is to be added to the CWF within
10 calendar days when the claim is suspended for MSP (internal system or CWF,
whichever suspends first) if no MSP record with the same MSP type already exists in
CWF.
A/B MACs will transmit "I" records to CWF via the current HUSP transaction. The CWF
will treat the "I" validity indicator the same as a "Y" validity indicator when processing
claims. Receipt of an "I" validity indicator will result in a CWF trigger to the MSP
Contractor. The MSP contractor will develop and confirm all "I" maintenance
transactions established by the A/B MAC. If the MSP contractor receives an affirmative
confirmation of MSP through its development efforts within 45 calendar days, the MSP
contractor will convert the “I” to a “Y” validity indicator. If the MSP contractor has not
received confirmation of MSP through its development efforts within 45 calendar days,
the MSP contractor will automatically delete the "I" validity indicator. Also, if the MSP
contractor develops and determines there is no MSP, the MSP Contractor will delete the
"I" record. An "I" record should never be established when the mandatory fields of
information are not readily available to an A/B MAC on a claim attachment. If the A/B
MAC has the actual date that Medicare became secondary payer, they use that as the
MSP effective date. If that information is not available, the A/B MAC shall use the Part
A entitlement date as the GHP MSP effective date. A/B MACs may include a termination
date when they initially establish an "I" record. However, they may not add a termination
date to an already established "I" record.
CWF accepts an "I" record only if no MSP record (validity indicator of either "I" or "Y,"
open, closed, or deleted status) with the same MSP type already exists on CWF with an
effective date within 45 calendar days of the effective date of the incoming "I" record.
Therefore, "I" records submitted to CWF before 45 calendar days have elapsed will reject
with an SP 20 error code. The resolution for these cases is to transfer all available
information to the MSP contractor via the Electronic Correspondence Referral System
(ECRS) CWF assistance request screen. It will be the responsibility of the MSP
contractor to reconcile the discrepancy and make any necessary modifications to the
CWF auxiliary file record.
A refund or returned check is no longer a justification for submission of an "I" record.
Since an "I" record does not contain the source (name and address) of the entity that
returned the funds, the MSP contractor lacks the information necessary to develop to that
source. Follow the examples below to determine which ECRS transaction to submit.
1. An MSP inquiry should be submitted when there is no existing or related MSP record
on the CWF. A “related” record means if an MSP record on CWF matches and has the
same HICN/MBI, MSP type, MSP effective date, Insurance type, patient relationship
code, and validity indicator.
2. The CWF assistance request should be submitted when the information on the CWF is
incorrect or the MSP record has been deleted.
3. The check or voluntary refund either opens and/or closes the MSP case or MSP issue.
Under these circumstances, the A/B MACs or DME MACs shall submit an MSP inquiry
to open or close the MSP record. Note: The A/B MACs or DME MACs should refer to
the ECRS manual for more information regarding closed cases.
The check should be deposited to unapplied cash until the MSP contractor makes an MSP
determination.
30 - CWF, MSP Auxiliary File
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
A maximum number of 17 MSP auxiliary records may be stored in CWF for each
beneficiary. The MSP Contractor is responsible for deletion of a record when the
maximum storage is exceeded using the following priority:
• Oldest "deleted" (flagged for deletion) occurrence;
• Oldest "confirmed no" occurrence;
• Oldest termination date; or
• Oldest maintenance date for the MSP type to be added.
30.1 - Integrity of MSP Data
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
The CWF MSP data base integrity is totally dependent upon MSP Contractor input,
supported by input by A/B MACs and DME MACs to the MSP Contractor. The MSP
Contractor is responsible for submitting to CWF MSP information it believes to be of the
highest quality. It shall investigate information thoroughly before making changes to an
existing CWF MSP auxiliary record.
30.1.1 - MSP Effective Date Change Procedure
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
When the MSP Contractor becomes aware that an MSP effective date is incorrect, it shall
perform the following functions:
• Delete the auxiliary record containing the incorrect MSP effective date using an
MSP delete transaction; and
• Submit a CWF, MSP maintenance transaction with the correct MSP effective date
to establish a new auxiliary record.
NOTE: When the beneficiary is entitled to both Parts A and B, the MSP Contractor shall
use the Part A entitlement date, if the insurance effective date is prior to entitlement to
Medicare.
30.1.2 - CWF/MSP Transaction Request for Contractor Assistance
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
Instances occur when the A/B MAC or DME MAC determines that the MSP effective date
is not correct. When this happens, the contractor shall advise the MSP Contractor, via
ECRS, of the need to change the MSP effective date and shall provide the MSP
Contractor with documentation to substantiate the change.
30.2 - MSP Termination Date Procedure
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
A. Future Termination Dates
For Non-GHP records, the termination date edits identified for GHP do not apply
as the termination date may be more than 6-months from the MSP effective date.
For GHP records, the termination date cannot be greater than the current date plus 6
months, except for MSP code = B; and for GHP records, the termination date cannot be
greater than the first day the beneficiary turned 65 if the MSP code is B or G. For
ESRD, CWF uses the following criteria:
• MSP effective date prior to February 1, 1990, allows for termination date up to 12
months after the effective date;
• MSP effective date February 1, 1990, through February 29, 1996, allows for
termination date up to 18 months after the effective date; or
• MSP effective date March 1, 1996, and later allows for termination date up to 30
months after the effective date.
B. Termination for "Y" Validity Indicator
A CWF MSP auxiliary record with a "Y" validity indicator establishes Medicare as the
secondary payer. When posting a termination date to this record, the "Y" validity
indicator should not be changed. The record indicates a valid MSP occurrence and all
future claims submitted will edit against the time frame posted. The A/B MAC or DME
MAC shall advise the MSP Contractor via ECRS when MSP no longer applies, and the
MSP Contractor shall enter the termination date.
30.3 - MSP Auxiliary File Errors
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
The term Medicare beneficiary identifier (Mbi) is a general term describing a
beneficiary's Medicare identification number. For purposes of this manual, Medicare
beneficiary identifier references both the Health Insurance Claim Number (HICN) and
the Medicare Beneficiary Identifier (MBI) during the new Medicare card transition
period and after for certain business areas that will continue to use the HICN as part of
their processes.
Maintenance transactions to the MSP Auxiliary file reject invalid data with errors
identified by a value of "SP" in the disposition field on the Reply Record. A trailer of
"08" containing up to four error codes will always follow. Listed below are the possible
MSP Maintenance Transaction error codes with a general description.
Error
Code
Definition
Valid Values
SP11
Invalid MSP transaction record type
"HUSP," "HISP," or "HBSP"
SP12
Invalid Medicare beneficiary identifier
Valid Medicare beneficiary
identifier
SP13
Invalid Beneficiary Surname
Valid Surname
SP14
Invalid Beneficiary First Name Initial
Valid Initial
SP15
Invalid Beneficiary Date of Birth
Valid Date of Birth
SP16
Invalid Beneficiary Sex Code
0=Unknown, 1=Male,
2=Female
SP17
Invalid Contractor Number
CMS Assigned Contractor
Number
SP18
Invalid Document Control Number
Valid Document Control
Number
SP19
Invalid Maintenance Transaction Type
0=Add/Change MSP Data
transaction, 1=Delete MSP
Data Transaction
SP20
Invalid Validity Indicator
Y= Beneficiary has MSP
Coverage,
I= Entered by the A/B MAC or
DME MAC – MSP Contractor
investigate,
N -No MSP coverage
SP21
Invalid MSP Code
A=Working Aged
B=ESRD
C= Conditional Payment
D= No Fault
E= Workers' Compensation
Error
Code
Definition
Valid Values
F= Federal
G= Disabled
H= Black Lung
L= Liability
SP22
Invalid Diagnosis Code 1-5
Valid Diagnosis Code
SP23
Invalid Remarks Code 1-3
See the Valid Remarks Codes
Below
SP24
Invalid Insurer Type
See definitions of Insurer
Type codes below
SP25
Invalid Insurer Name
An SP25 error is returned when the MSP
Insurer Name is equal to one of the
following:
Supplement
Supplemental
Insurer
Miscellaneous
CMS
Attorney
Unknown
None
N/A
Un
Misc
NA
NO
BC
BX
BS
BCBX
Blue Cross
Blue Shield
Medicare
Medicaid
Alphabetic, Numeric, Space,
Comma, & - ' . @ # / ; :
Insurer Name must be present
if Validity Indicator = Y
SP26
Invalid Insurer Address 1 and/or Address
2
Alphabetic, Numeric, Space,
Comma, & - ' . @ # / ; :
Error
Code
Definition
Valid Values
SP27
Invalid Insurer City
Alphabetic, Numeric, Space,
Comma, & - ' . @ # / ; :
SP28
Invalid Insurer State
Must match U.S. Postal
Service state abbreviation
table.
SP29
Invalid Insurer Zip Code
If present, 1st 5 digits must be
numeric. If foreign country
"FC" state code, the nine
positions may be spaces.
SP30
Invalid Policy Number
Alphabetic, Numeric, Space,
Comma, & - ' . @ # / ; :
SP31
Invalid MSP Effective Date (Mandatory)
Non-blank, non-zero, numeric,
number of days must
correspond with the particular
month. MSP Effective Date
must be no more than 3
months in the future from the
current date.
SP32
Invalid MSP Termination Date
Must be numeric; may be all
zeroes if not used; if used, date
must correspond with the
particular month for GHP
records. The MSP
Termination Date is Greater
than Six Months from the
current date for non-Group
Health Plan MSP Auxiliary
Records.
SP33
Invalid Patient Relationship
The following codes are valid
for all MSP Auxiliary
occurrences regardless of
accretion date:
01 = Self; the beneficiary is
the policy holder or subscriber
for the other GHP insurance
reflected by the MSP
occurrence –or- Beneficiary is
the injured party on the
Workers Compensation, No-
Fault, or Liability claim
02 =Spouse or Common Law
Spouse
Error
Code
Definition
Valid Values
03 = Child
04 = Other Family Member
20 = Life Partner or Domestic
Partner
The following codes are only
valid on MSP Auxiliary
occurrences with accretion
dates PRIOR TO 4/4/2011:
05 = Step Child
06 = Foster Child
07 = Ward of the Court
08 = Employee
09 = Unknown
10 = Handicapped
Dependent
11 = Organ donor
12 = Cadaver Donor
13 = Grandchild
14 = Niece/Nephew
15 = Injured Plaintiff
16 = Sponsored Dependent
17 = Minor Dependent of a
Minor Dependent
18 = Parent
19 =
Grandparent
20 = Life Partner or Domestic
Partner
SP34
Invalid subscriber First Name
Alphabetic, Numeric, Space,
Comma, & - ' . @ # / ; :
SP35
Invalid Subscriber Last Name
Alphabetic, Numeric, Space,
Comma, & - ' . @ # / ; :
SP36
Invalid Employee ID Number
Alphabetic, Numeric, Space,
Comma, & - ' . @ # / ; :
SP37
Invalid Source Code
Spaces, A through W, 0 – 19,
21, 22, 25, 26, 39, 41, 42, 43.
See §10.2 for definitions of
valid CWF Source Codes.
Error
Code
Definition
Valid Values
SP38
Invalid Employee Information Data Code
Spaces if not used, alphabetic
values P, S, M, F. See §30.3.4
for definition of each code.
SP39
Invalid Employer Name
Spaces if not used. Valid
Values:
Alphabetic, Numeric, Space,
Comma, & - ' . @ # / ; :
SP40
Invalid Employer Address
Spaces if not used. Valid
Values:
Alphabetic, Numeric, Space,
Comma, & - ' . @ # / ; :
SP41
Invalid Employer City
Spaces if not used. Valid
Values:
Alphabetic, Numeric, Space,
Comma, & - ' . @ # / ; :
SP42
Invalid Employer State
Must match U.S. Postal
Service state abbreviations.
SP43
Invalid Employer ZIP Code
If present, 1st 5 digits must be
numeric. If foreign country
‘FC’ is entered as the state
code, and the nine positions
may be spaces.
SP44
Invalid Insurance Group Number
Spaces if not used. Valid
Values:
Alphabetic, Numeric, Space,
Comma, & - ' . @ # / ; :
SP45
Invalid Insurance Group Name
Spaces if not used. Valid
Values:
Alphabetic, Numeric, Space,
Comma, & - ' . @ # / ; :
SP46
Invalid Pre-paid Health Plan Date
Numeric; number of days
must correspond with the
particular month.
SP47
Beneficiary MSP indicator not on for
delete transaction.
Occurs when the code
indicating the existence of
MSP auxiliary record is not
equal to "1" and the MSP
maintenance transaction type
is equal to ‘1.’
SP48
MSP auxiliary record not found for delete
data transaction
See MSP Auxiliary Record
add/update and delete function
procedures above.
Error
Code
Definition
Valid Values
SP49
MSP auxiliary occurrence not found for
delete data transaction
See MSP Auxiliary Record
add/update and delete function
procedures above.
SP50
Invalid function for update or delete
Contractor number unauthorized
See MSP Auxiliary Record
add/update and delete function
procedures above
SP51
MSP Auxiliary record has 17 occurrences
and none can be replaced
SP52
Invalid Patient Relationship Code which
is mandatory for MSP Codes A, B and G
when the Validity Indicator is "Y"
Accretion Dates prior to
4/4/2011:
Patient Relationship must be
01 or 02 for MSP Code A
(Working Aged).
Patient Relationship must be
01, 02, 03, 04, 05, 18 or 20 for
MSP Codes B (ESRD) and G
(Disabled).
Accretion Dates 4/4/2011 and
subsequent:
Patient Relationship must be
01 or 02 for MSP Code A
(Working Aged).
Patient Relationship must be
01, 02, 03, 04, or 20 for MSP
Codes B (ESRD) and G
(Disabled).
SP53
The maintenance transaction was for
Working Aged EGHP and there is either a
ESRD EGHP or Disability EGHP entry
on file that has a termination date after the
Effective date on the incoming transaction
or is not terminated, and the contract
number on the maintenance transaction is
not equal to "11102," "11104," “11105,"
"11106," "33333," "66666,", "77777,"
"88888," or "99999."
SP54
MSP Code A, B or G has an Effective
date that is in conflict with the calculated
age 65 date of the Bene.
For MSP Code A, the
Effective date must not be less
than the date at age 65. For
MSP Code G, the Effective
date must not be greater than
the date at age 65.
SP55
MSP Effective date is less than the earliest
Error
Code
Definition
Valid Values
Bene Part A or Part B Entitlement Date.
SP56
MSP Prepaid Health Plan Date must be =
to or greater than MSP Effective date or
less than MSP Termination date.
SP57
Termination Date Greater than 6 months
prior to date added for Contractor
numbers other than 11100 – 11119,
11121, 11122, 11126, 11139, 11141,
11142, 11143, 33333, 55555, 77777,
88888, and 99999.
SP58
Invalid Insurer type, MSP code, and
validity indicator combination.
If MSP code is equal to "A" or
"B" or "G" and validity
indicator is equal to "I" or "Y"
then insurer type must not be
equal to spaces. Mapped
coverage type must equal “J”,
“K”, or “A”.
SP59
Invalid Insurer type, and validity indicator
combination
If validity indicator is equal to
"N" then insurer type must be
equal to spaces.
SP60
Other Insurer type for same period on file
(Non "J" or "K") Insurer type on incoming
maintenance record is equal to "J" or "K"
and Insurer type on matching aux record
is not equal to "J" or "K."
Edit applies only to MSP
codes:
A - Working Aged,
B - ESRD EGHP,
G - Disability EGHP
SP61
Other Insurer type for same period on file
("J" or "K") Insurer type on incoming
maintenance record is not equal to "J" or
"K" and Insurer type on matching aux
record is equal to "J" or "K."
Edit applies only to MSP
codes:
A - Working Aged,
B - ESRD EGHP,
G - Disability EGHP
SP62
Incoming term date is less than MSP
Effective date.
SP66
MSP Effective date is greater than the
Effective date on matching occurrence on
auxiliary file
SP67
Incoming term date is less than posted
term date for Provident
SP72
Invalid Transaction attempted
A HUSP add transaction is
received from a A/B MAC and
DME MAC (non-MSP
Contractor) with a validity
indicator other than "I."
SP73
Invalid Term Date/Delete Transaction
A MAC attempts to change a
Term Date on an MSP
Error
Code
Definition
Valid Values
Auxiliary record with a "I" or
"Y" Validity Indicator that is
already terminated, or trying
to add Term Date to "N"
record.
SP74
Invalid cannot update "I" record.
A MAC submits a HUSP
transaction to update/change
an "I" record or to add an "I"
record and a match MSP
Auxiliary occurrence exists
with a "I" validity indicator.
SP75
Invalid transaction, no Medicare Part A
benefits
A HUSP transaction to add a
record with a Validity
Indicator equal to "I" (from an
A/B MAC or DME MAC) or
"Y" (from the MSP
Contractor) with an MSP
Type equal to "A," "B," "C,"
or "G" and the effective date
of the transaction is not within
a current or prior Medicare
Part A entitlement period, or
the transaction is greater than
the termination date of a
Medicare entitlement period.
SP76
MSP Type is equal to W (Workers’
Compensation Medicare Set-Aside) and
there is an open MSP Type E (Workers’
Compensation) record.
SP77
A diagnosis cannot be added to this
occurrence by a Part A/Part B/DME
MAC.
SP78
The diagnosis code submitted is not
allowed on an MSP Type 'D' record.
When an incoming HUSP
transaction with a Validity
Indicator equal to 'I' or 'Y' is
received from an
A/B, DME MAC or the MSP
Contractor for an MSP Type
'D'
record, and the transaction
contains one of the CMS
identified ICD 9 or ICD 10
diagnosis codes.
Error
Code
Definition
Valid Values
SP79
A MAC attempts to create/enter a value in
the ORM field on the incoming I HUSP
record (makes sure that a MAC cannot
update or overlay an ORM value in the
ORM field).
Valid Values for the 1-byte
ORM indicator on the CWF
MSP Detail screen (MSPD)
are: Y (Yes) or a space.
A “Y” ORM indicator value
denotes that the ORM existed
for a period of time, not
necessarily that it currently
exists. An ORM indicator of a
“space” implies that an RRE
has not assumed ORM.
SP80
A MAC attempted to create/enter an
ORM indicator on an MSP record other
than a D, E, and L.
The 1- byte ORM indicator
(valid values = Y or a space)
shall only be received on
HUSP transactions with MSP
Codes “D, E, and L.”
SP81
A contractor, other than the following
contractor numbers of 11100, 11110,
11122, 11141, and 11142, attempts to
update, remove or set the existing ORM
record indicator of a “Y” to a “space.”
To ensure that no other entity
than the following contractor
numbers (11100, 11110,
11122, 11142, and 11142) can
modify an existing record’s
ORM indicator to equal a
“space,” if originally it was a
“Y.”
SP82
MSP Type 'L' or 'D' does not exist.
When an incoming HUSP
transaction is submitted for
LMSA (MSP Type S) and no
Liability (MSP Type L) MSP
Auxiliary record exists; or
when an incoming HUSP
transaction is submitted for
NFMSA (MSP Type T) and
no No-Fault Auto (MSP Type
D) MSP Auxiliary record
exists.
SP83
No Termination Date present for a
Liability or No-Fault Auto occurrence.
When an incoming HUSP
transaction is submitted for
LMSA (MSP Type S) and the
Liability (MSP Type L) record
on the MSP Auxiliary File
does not have a Termination
Date; or when an incoming
HUSP transaction is submitted
Error
Code
Definition
Valid Values
for NFMSA (MSP Type T)
and the No-Fault Auto (MSP
Type D) record on the MSP
Auxiliary File does not have
Termination Date.
SP84
Invalid Effective date for LMSA or
NFMSA or open record.
An HUSP transaction is
submitted by contractor
'11144'
or '11100' for LMSA (MSP
Type S) and posted to the
MSP Aux
file is a Liability (MSP Type
L) with a Termination Date.
If the Effective Date of the
LMSA (MSP Type S) is not
one day after the Termination
Date of the Liability
(MSP Type L).
If the Effective Date of the
LMSA (MSP Type S) is
one day after the Termination
Date of the Liability (MSP
Type L), and the diagnosis
codes on the LMSA (MSP
Type S)
are not an Exact or not a
Family Match with the
Liability
(MSP Type L) diagnosis
codes.
AND/OR
An HUSP transaction is
submitted by contractor
'11145'
or '11100' for NFMSA (MSP
Type T) and posted to the
MSP Aux
file is a No-Fault (MSP Type
D) with a Termination Date.
If the Effective Date of the
NFMSA (MSP Type T) is not
one day after the Termination
Date of the No-Fault (MSP
Type D).
Error
Code
Definition
Valid Values
If the Effective Date of the
NFMSA (MSP Type T) is
one day after the Termination
Date of the No-Fault (MSP
Type D), and the diagnosis
codes on the NFMSA (MSP
Type T)
are not an Exact or not a
Family Match with the No-
Fault
(MSP Type D).
SP91
Invalid Employer Size (Mandatory). Field
must contain a numeric
character.
SP99
Medicare ID (HICN or MBI) required if
individual is less than 45
years of age.
30.3.1 - Valid MSP Remarks Codes
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
MSP
Remark
Code
Definition
01
Beneficiary retired as of termination date.
02
Beneficiary's employer has less than 20 employees.
03
Beneficiary's employer has less than 100 employees
04
Beneficiary is dually entitled to Medicare, based on ESRD and Age or ESRD
and disability
05
Beneficiary is not married.
06
The Beneficiary is covered under the group health plan of a family member
whose employer has less than 100 employees.
07
Beneficiary's employer has less than 20 employees and is in a multiple or
multi-employer plan that has elected the working aged exception.
08
Beneficiary's employer has less than 20 employees and is in a multiple or
multi-employer plan that has not elected the working aged exception.
09
Beneficiary is self-employed.
10
A family member of the Beneficiary is self-employed.
20
Spouse retired as of termination date.
21
Spouse's employer has less than 20 employees.
22
Spouse's employer has less than 100 employees.
23
Spouse's employer has less than 100 employees but is in a qualifying multiple
or multi-employer plan.
MSP
Remark
Code
Definition
24
Spouse's employer has less than 20 employees and is multiple or multi-
employer plan that has elected the working aged exception.
25
Spouse's employer has less than 20 employees and is multiple or multi-
employer plan that has not elected the working aged exception.
26
Beneficiary's spouse is self-employed
30
Exhausted benefits under the plan
31
Preexisting condition exclusions exist
32
Conditional payment criteria met
33
Multiple primary payers, Medicare is tertiary payer
34
Information has been collected indicating that there is not a parallel plan that
covers medical services
35
Information has been collected indicating that there is not a parallel plan that
covers hospital services
36
Denial sent by EGHP, claims paid meeting conditional payment criteria.
37
Beneficiary deceased.
38
Employer certification on file.
39
Health plan is in bankruptcy or insolvency proceedings.
40
The termination date is the Beneficiary's retirement date.
41
The termination date is the spouse's retirement date.
42
Potential non-compliance case, Beneficiary enrolled is supplemental plan.
43
GHP coverage is a legitimate supplemental plan.
44
Termination date equals transplant date
50
Employment related accident
51
Claim denied by workers comp
52
Contested denial
53
Workers compensation settlement funds exhausted
54
Auto accident - no coverage
55
Not payable by black lung
56
Other accident - no liability
57
Slipped and fell at home
58
Lawsuit filed - decision pending
59
Lawsuit filed - settlement received
60
Medical malpractice lawsuit filed
61
Product liability lawsuit filed
62
Request for waiver filed
70
Data match correction sheet sent
71
Data match record updated
72
Vow of Poverty correction
30.3.2 - Valid MSP Insurance Type Codes
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
MSP
Insurer
Type Code
Definition
A
GHP Hospital and Medical Coverage -or- Other Non-GHP
B
GHO
C
Preferred Provider Organization (PPO)
D
Third Party Administrator arrangement under an Administrative Service Only (ASO)
contract without stop loss from any entity.
E
Third Party Administrator arrangement with stop loss insurance issued from any entity.
F
Self-Insured/Self-Administered.
G
Collectively-Bargained Health and Welfare Fund.
H
Multiple Employer Health Plan with at least one employer who has more than 100 full
and/or part-time employees.
I
Multiple Employer Health Plan with at least one employer who has more than 20 full
and/or part-time employees.
J
GHP Hospitalization Only Plan - A plan that covers only Inpatient hospital services.
K
GHP Medical Services Only Plan - A plan that covers only non-inpatient medical
services.
M Medicare Supplemental Plan, Medigap, Medicare Wraparound Plan or Medicare Carve
Out Plan.
R GHP Health Reimbursement Arrangement
S GHP Health Savings Account
SPACES Unknown
NOTE: For MSP occurrences with accretion dates of 4/4/2011 and subsequent, the
only valid Insurer Type Codes are A, J, K, R, S, and spaces.
30.3.3 - Other Effective Date and Termination Date Coverage Edits
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
If MSP Code:
MSP Effective Date Must Be Greater
Than
A - Working Aged
January 1, 1983 (830101)
A - Working Aged
Calculated Date beneficiary turned 65 (first
day of month).
B – ESRD
October 1, 1981
D - No Fault
December 1, 1980
E - Workers' Compensation
July 1, 1966
F - Federal/Public Health
July 1, 1966
If MSP Code:
MSP Effective Date Must Be Greater
Than
H - Black Lung
July 1, 1973
G - Disabled (43)
January 1, 1987
G – Disabled
Prior to the first day of the month the
Beneficiary turns 65.
L – Liability
December 1, 1980
Other Termination date coverage edits are:
• For Group Health Plan (GHP) records the termination date cannot be greater than
the current date plus six months, except for MSP code = B, and
• For GHP records the termination date cannot be greater than the first day the
beneficiary turned 65 if the MSP code is B or G.
Note: For Non-GHP records the termination date edits identified above do not
apply as the termination date may be more than 6-months from the MSP effective
date.
30.3.4 - MSP Employee Information Data Code
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
MSP Employee Information Data Code
Valid Values
P
Patient
S
Spouse
M
Mother
F
Father
30.4 - Automatic Notice of Change to MSP Auxiliary File
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
The Common Working File (CWF) sends MSP transactions to all contractors of record
when an MSP auxiliary record is created or changed for any beneficiary.
Alerts are sent to the A/B MACs and DME MACs when an update is made to an MSP
record.
40 - MSP Claim Processing
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
The CWF performs consistency edit checks on claims submitted to it. Refer to CWF
Systems Documentation for the complete record layout and field descriptions. Record
names are:
• CWF Part B Claim Record, and
• CWF Inpatient/SNF Bill Record.
The MSP claims failing the consistency edits shall receive a reject with the appropriate
disposition code, reject code, and MSP trailer data. Refer to CWF Systems
Documentation, Record Name: CWF, MSP Basic Reply Trailer Data for the complete
record layout and field descriptions. Claims passing the consistency edit process are
reviewed for utilization compliance. Claims rejected by the utilization review process are
rejected with the appropriate disposition code, reject code and MSP trailer data.
40.1 - CWF, MSP Claim Validation
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
There are four conditions that may occur when an A/B MAC and DME MAC validates
claims against the CWF, MSP auxiliary file:
• MSP is indicated on the claim and there is matching data on the CWF, MSP
auxiliary record. The claim is accepted and all CWF, MSP auxiliary occurrences
are returned,
• MSP is indicated on the claim and there is no matching data on an MSP auxiliary
record. The claim is rejected and all CWF, MSP occurrences that apply are
returned. Section 40.8 describes the CWF, MSP Utilization Error Codes, and the
appropriate resolution for those codes,
• MSP is not indicated on the claim and the MSP auxiliary file has an occurrence
that indicates there is MSP involvement for the time period affected. The claim is
rejected and all occurrences that apply are returned, and
• MSP is not indicated on the claim and there are no matching occurrences on the
CWF, MSP auxiliary file that indicate MSP involvement. The claim is accepted
for payment.
NOTE: An occurrence applies if the claim service dates are equal to, or greater than, the
effective date of the occurrence and less than, or equal to, the termination date of that
occurrence, if there is a termination date.
40.2 - CWF Claim Matching Criteria Against MSP Records
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
The matching criteria between the claim and the MSP auxiliary occurrence in CWF is as
follows:
HICN/MBI, MSP type, MSP effective date and termination date, insurance type, patient
relationship code and validity indicator for the same insurer. Note, NGHP records
includes matching on the family of diagnosis codes.
40.3 - Conditional Payment
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
To make a conditional payment, A/B MACs and DME MACs indicate conditional
payment on the CWF, Part B Claim by placing a "C" in the "MSP code" field (field 97 of
the CWF Part B Claim record.). Intermediaries indicate conditional payment on the CWF
Inpatient/SNF Bill by placing zeros (0) in the "value amount" field (position 77b)
along with the appropriate "value code." An MSP auxiliary record for the beneficiary
with a "Y" validity indicator must be present. The CWF will reject the claim with error
code 6805 when a claim for conditional payment is submitted and there is no matching
MSP auxiliary record present.
40.4 - Override Codes
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
The CWF will accept MSP override codes. A/B MACs or DME MACs must place the
appropriate override code in the "MSP code" field (field 97) of the CWF Part B Claim
record. Intermediaries must place the appropriate override code in the CWF
(Inpatient/SNF Bill or Outpatient/Home Health/Hospice), "Special Action Code/Override
Code, field 90." Override codes must be used only as described below.
The CWF employs the following matching criteria for override codes "M" and "N":
• Dates of service on the claim fall within the effective and termination dates on
auxiliary record; and
• Validity indicator is equal to "Y."
The correct use of override codes is as follows:
A. Override code "M" is used where GHP, LGHP and ESRD services are involved
and the service provided is either:
• Not a covered service under the primary payer's plan;
• Not a covered diagnosis under the primary payer's plan; or
• Benefits have been exhausted under the primary payer's plan.
B. Override code "N" is used where non-GHP (auto medical, no-fault, liability,
Black Lung, and workers' compensation) services are involved and the service is
either:
• Not a covered service under the primary payer's plan;
• Not a covered diagnosis under the primary payer's plan; or
• Benefits have been exhausted under the primary payer's plan.
Contractors receive error code 6806 when the MSP override code equals "M" or "N" and
no MSP record is found with overlapping dates of service.
40.5 - MSP Cost Avoided Claims
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
A/B MACs and DME MACs shall follow the instructions cited in Pub. 100-05, Chapter 5
for counting savings on MSP cost avoided claims.
They shall submit ALL MSP cost avoided claims to CWF.
Payment/Denial codes are used to identify the reason a claim was denied. Specific codes
for MSP are listed and defined in §10.2 under the MSP/ Contractor Number chart in
that section. A/B MACs (Part B) and DME MACs submit the appropriate code to CWF in
the Health Utilization Part B Claim ("HUBC") claim record in field 63 "Payment/Denial
Code" for line item denials. They complete the appropriate code for full claim denials in
the "HUBC" claim record, field 16 "Payment/Denial". A/B MACs (Part A) submit the
appropriate code in the Health Utilization Inpatient Claim (HUIP) CWF record field 58
"Nonpayment" code for inpatient hospital and SNF claim denials. They submit the
appropriate code in field 59 "No Pay Code" of the CWF record for the specific type of
claim identified in the chart below.
PAYMENT/DENIAL CODE FIELDS IN CWF CLAIM RECORD
Contractor
Type of Claim
CWF
Record
Field
A/B MAC (Part B)
and DME MAC
Full Claim Denial
HUBC
16 Payment/Denial
A/B MAC (Part B)
and DME MAC
Full Line Item
Denial
HUBC
63 Payment/Denial Code
A/B MAC (Part A)
and DME MAC
Inpatient hospital
and inpatient SNF
Denial
HUIP
58 Nonpayment Code
A/B MAC (Part A)
and DME MAC
Health Utilization
Outpatient (HUOP)
HUOP
59 No Pay Code
Contractor
Type of Claim
CWF
Record
Field
A/B MAC (HH&H)
Health Utilization
Home Health
(HUHH)
HUHH
59 No Pay Code
A/B MAC (HH&H)
Health Utilization
Hospice Claim
(HUHC)
HUHC
59 No Pay Code
If a denial indicator is incorrect, the CWF software will correct the denial indicator based
on the matching MSP auxiliary record and send the correct value back to the contractor
on the response record header. It is not necessary for an MSP auxiliary record to be
present in order to post MSP cost avoided savings. If one is present, the A/B MAC or
DME MAC uses the "X" or "Y" override code as appropriate.
40.6 - Online Inquiry to MSP Data
(Rev. 125, Issued: 03-22-19, Effective: 04-22-19, Implementation: 04-22-19)
The term Medicare beneficiary identifier (Mbi) is a general term describing a
beneficiary's Medicare identification number. For purposes of this manual, Medicare
beneficiary identifier references both the Health Insurance Claim Number (HICN) and
the Medicare Beneficiary Identifier (MBI) during the new Medicare card transition
period and after for certain business areas that will continue to use the HICN as part of
their processes.
The MSP data may be viewed online in CWF via the HIMR access. The user enters the
transaction HIMR, which displays the HIMR Main Menu, and enters the MSPA
selection. (A complete record layout and field descriptions can be found in the CWF
Systems Documentation at http://cms.csc.com/cwf/, Record Name: MSP Auxiliary File
and MSP Audit History File.)
A user can view a selected CWF, MSP auxiliary record by following the steps outlined
below:
A. Enter the Medicare beneficiary identifier and MSP record type.
If the data entered is invalid, an error message is displayed with the field in error
highlighted. If the data entries are valid, a search is done of the beneficiary master file for
an MSP indicator. The search of the master file will show one of the following:
• The MSP indicator on the beneficiary file is not set. In this case the message
"MSP not indicated" is displayed;
• No record is found. In this case, a message "MSP auxiliary file not found" is
displayed; or
• MSP is indicated. In this case, the MSP auxiliary file is read and the screen will
display an MSP Record.
A successful reading of the MSP file, as noted in the third bullet above, will display an
MSP occurrence summary screen that includes:
• Summary selection number;
• MSP code;
• MSP code description;
• Validity indicator;
• Delete indicator;
• Effective date; and
• Termination date, if applicable.
B. Enter the summary selection number on the MSP occurrence summary screen.
This results in a display of the MSP occurrence detail screen for the selected MSP
occurrence. The MSP occurrence detail screen is a full display of the information on the
MSP auxiliary file for the particular MSP occurrence.
40.7 - MSP Purge Process
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
The CWF process includes an MSP purge process. The CMS will determine when the
purge process will be employed. The criteria for deletion of MSP data from the CWF
MSP auxiliary file will be a predetermined number of years from the following dates:
• Date of death;
• Termination date and last maintenance date; or
• Last maintenance date and delete indicator equal to "D."
The MSP purge criteria will be parameter driven. All occurrences of MSP data for a
beneficiary will be copied to the MSP history audit file, and the MSP indicator on the
beneficiary file will be disengaged (turned off) if no other occurrences are present on the
file.
A Summary report, by originating contractor identification number, will contain the total
number of MSP records affected by the purge and the total of each type of MSP
occurrence deleted from the MSP auxiliary file.
40.8 - MSP Utilization Edits and Resolution for Claims Submitted to
CWF
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
Error
Code
Error Description
Resolution
6801
GHP MSP indicated on claim - no
MSP auxiliary record exists on CWF
data base.
Prepare an "I" MSP maintenance
transaction and resubmit claim to
CWF. See §10.1 for criteria to submit
"I". If "I" criteria is not met, submit an
MSP inquiry via ECRS.
6802
GHP MSP indicated on claim - no
match on MSP auxiliary file.
(1) Analyze CWF auxiliary file.
(2) Create a new "I" MSP auxiliary
record, or if "I" record criteria is not
met, submit an MSP inquiry or CWF
assistance request via ECRS; and
(3) Resubmit claim.
NOTE: Match criteria: MSP types are equal, validity indicator equals "Y," dates of
service are within MSP period and NO override code is indicated on claim.
6803
GHP MSP auxiliary record exists - no
GHP
MSP indicated on claim but dates
of service match a GHP occurrence.
(1) Deny claim. Advise
beneficiary/provider: "Resubmit
claim with other payer's Explanation
of Benefits for possible secondary
payment. If other insurance has
terminated, resubmit with
documentation showing termination
dates of other insurance." If you have
documentation showing termination
of the insurance coverage indicated in
the CWF, MSP occurrence, process
as follows:
(2) Post a termination date; or
(3) Resubmit claim as MSP.
If the termination date is incorrect,
submit a CWF assistance request via
ECRS.
6805
GHP MSP conditional payment claim
and matching MSP record with “I”or
"Y" validity indicator not found for
these dates of service.
(1) A/ B MACs only: Create an "I"
MSP Auxiliary Record when it fits
the criteria for adding an "I" record.
(2) Submit MSP inquiry or CWF
assistance request via ECRS.
Error
Code
Error Description
Resolution
(3) Resubmit claim.
6806
MSP override code equals "M" and no
GHP MSP record found with
overlapping dates of service.
If record was deleted in error, request
CWF assistance request. Do not
recreate record with "I" validity
indicator.
6810
Part A claim was processed and only a Part B (Insurer type = "K") matching
record was found.
6811
Part B claim was processed and only a Part A (Insurer type = "J") matching
record was found.
6815
WC Medicare Set-Aside exists (Insurer type= “W”). Medicare contractor
payment not allowed.
6816
No-Fault over-rideable utilization error code to be used when a valid (Y)
ORM indicator is on the MSP CWF auxiliary file and the diagnosis codes on
the claim match the diagnosis codes (or match within the family of diagnosis
codes) on the open MSP ORM record on CWF. MACs shall deny the
claim(s) as a Medicare payment is not allowed.
6817
Workers’ Compensation over-rideable utilization error code to be used when
a valid (Y) ORM indicator is on the MSP CWF auxiliary file and the
diagnosis codes on the claim match the diagnosis codes (or match within the
family of diagnosis codes) on the open MSP ORM record on CWF. MACs
shall deny the claim(s) as a Medicare payment is not allowed.
6818
Liability over-rideable utilization error code to be used when a valid (Y)
ORM indicator is on the MSP CWF auxiliary file and the diagnosis codes on
the claim match the diagnosis codes (or match within the family of diagnosis
codes) on the open MSP ORM record on CWF. MACs shall deny the
claim(s) as a Medicare payment is not allowed.
6819 A non-GHP ('D', 'H' or 'L') MSP auxiliary record exists, and no non-GHP
MSP is indicated on the claim, but the Dates of Service match, the diagnosis
on the claim is a match within the family of diagnosis codes OR a non-GHP
('E') MSP auxiliary record exists, and no non-GHP MSP is indicated on the
claim, but the Dates of Service match, the diagnosis on the claim is an exact
match or a match within the family of diagnosis codes.
6821 Non-GHP MSP indicated on claim; no MSP Auxiliary file exists. This
indicates no Non-GHP MSP file found.
6822 Non-GHP MSP indicated on the claim; a Non-GHP match does not exist on
MSP Auxiliary file.
6823 Beneficiary has a non-GHP MSP Type record 'S' on the Auxiliary file; there is
a matching diagnosis on the claim and auxiliary file, and the claim contains
payment (full or conditional).
6824 Beneficiary has a non-GHP MSP Type record 'T' on the Auxiliary file; there is
a matching diagnosis on the claim and auxiliary file, and the claim contains
payment (full or conditional).
6825 Non-GHP MSP conditional payment claim, but a non-GHP MSP record with
a Validity Indicator equal to 'I' or 'Y' is not present for these Dates of Service.
6826 MSP Override Code is 'N' or Cost Avoid and no non-GHP MSP record is
found with overlapping Date of Service.
6830 Part A claim was processed and only a Part B (Insurer Type 'K') matching
non-GHP record was found.
6832 The non-GHP MSP occurrence ('D', 'E', 'H', 'L', 'S', 'T', or 'W') does not
contain a diagnosis code.
6833 The ICD-9 diagnosis on the claim is not an exact or Family match to the ICD-
10 diagnosis on the open non-GHP MSP Aux record (Value Code '14' (MSP
Codes 'D' or 'T'), Value Code '15' (MSP Codes 'E' or 'W'), Value Codes '47'
(MSP Codes 'L' or 'S'), or
the ICD-10 diagnosis on the claim is not an exact or Family match to the
ICD-9 diagnosis on the open non-GHP MSP Aux record (Value Code '14'
(MSP Codes 'D' or 'T'), Value Code '15' (MSP Codes 'E' or 'W'), Value Codes
'47' (MSP Codes 'L' or 'S').
6834 When the claim is secondary and it shows there is a GHP insurer, but the MSP
record on CWF has only a non-GHP MSP occurrence.
6835 When the claim is secondary and it shows there is a non-GHP insurer, but the
MSP record on CWF has only a GHP MSP occurrence.
See discussion in §40.4 above for proper use of override codes.
40.9 - CWF MSP Reject for A Beneficiary Entitled to Medicare Part B
Only and A GHP
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
An MSP situation cannot exist when a beneficiary has GHP coverage (i.e., working aged,
disability and ESRD) and is entitled to Part B only. CWF will edit to prevent the posting
of these MSP records to CWF when there is no Part A entitlement date. Currently, if a
contractor submits an ECRS transaction to the MSP Contractor to add a GHP MSP
record where there is no Part A entitlement, the A/B MAC and DME MAC will receive a
reason code of 61, MSP cannot exist without Part A entitlement.
A/B MACs and DME MACs shall not submit an ECRS request to the MSP Contractor to
establish a GHP MSP record when there is no Part A entitlement. A/B MACs and DME
MACs that attempt to establish an “I” record will receive a CWF error.
The CWF shall continue to allow the posting of Part B MSP records where there is no
Part A entitlement when NGHP situations exists, such as automobile, liability, and
workers’ compensation. Where an NGHP situation exists, the A/B MAC and DME MAC
shall continue to submit ECRS transactions and establish “I” records, as necessary.
40.10 – ICD-10 and ICD 9-CM Diagnosis Code Tables Involving Non-
GHP MSP Claims
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
In accordance with The Health Insurance Portability and Accountability Act of 1996
(HIPAA), the Secretary of the Department of Health and Human Services adopts
standard medical data code sets for use in standard transactions. According to the ICD-
10 final rule, published in the Federal Register on January 16, 2009, the Secretary
adopted the ICD-10-CM and ICD-10- PCS code sets for use in appropriate HIPAA
standard transactions, including those for submitting health care claims electronically.
Entities covered under HIPAA, which includes Medicare and its providers submitting
claims electronically, are bound by these requirements and must comply. Medicare also
requires submitters of paper claims to use ICD-10 codes on their claims according to the
same compliance date.
CMS annually instructs CWF to upload and implement the ICD-10 tables in CWF for
NGHP MSP claims transactions. In order to be prepared to meet the time line to
implement the annually updated ICD-10 diagnosis codes by the mandated time frame of
October, CWF implements the ICD-10 updates effective with each October release. CMS
also provides CWF with the Diagnosis and Procedure Codes Conversion Tables that are
used to associate ICD-10 codes to ICD-9 codes found in CWF MSP records. CWF loads
and converts ICD-10 to ICD-9 diagnosis codes for purposes of determining whether ICD
10 diagnosis codes on incoming MSP claim are related to the NGHP MSP record in
CWF.
40.10.1 - Certain Diagnosis Codes Not Allowed on NGHP MSP Records
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
There are certain diagnosis codes that systems must not apply to MSP Type 14, CWF
MSP Type D No-Fault records and MSP Type 14, CWF MSP Type L Liability records
and MSP Type 15, CWF Type E or W, Workers’ Compensation records. In order for
these MSP claims not to deny and process correctly, the CWF must only allow those
diagnosis codes related to the accident or injury. CMS has provided a comprehensive list
of diagnosis codes that apply and do not apply to NF, L or WC MSP records. The list of
diagnosis codes and excluded diagnosis codes may be found at the Coordination of
Benefits Overview website at https://www.cms.gov/medicare/coordination-benefits-
recovery-overview/icd-code-lists.
50 - Special CWF Processes
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
Special CWF MSP Processes are identified below.
50.1 - Extension of MSP-ESRD Coordination Period
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
Section 4631(b), of the Balanced Budget Act (BBA) of 1997, permanently extends the
coordination period to 30 months for any individual whose coordination period began on
or after March 1, 1996. Therefore, individuals who have not completed an 18-month
coordination period by July 31, 1997, will have a 30-month coordination period under the
new law. The Common Working File (CWF) will deny claims for primary payment that
are submitted for applicable individuals during the 30-month coordination period. This
provision does not apply to individuals who would reach the 18-month point on or before
July 31, 1997. These individuals would continue to have an 18-month coordination
period.
A one-time utility program was executed in CWF to extend the ESRD coordination
period for applicable individuals (those records with a Medicare Secondary Payer (MSP)
code of "B" and a coordination period termination date of August 1997, or later) to 30
months. This was done by adding 12 months to all coordination periods with a
termination date on or after August 1997. All applicable records were changed by
September 1, 1997. Any open records (those which do not have a termination date)
remained open until they closed using the existing mechanisms, but following the time
guidelines outlined above. That is, any ESRD, MSP termination dates, which were added
to CWF where the coordination period ended in August 1997 or later, now reflect the
new 30-month period. Claims erroneously submitted for primary payment are rejected
with CWF Utilization Error Code 6803.
50.2 - MSP “W’ Record and Accompanying Processes
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
I. Common Working File Requirements (CWF)
CWF accepts an MSP code of “W” for Workers’ Compensation Medicare Set-Aside
Arrangements (WCMSA) for use on the HUSP records for application on the HUSP
Auxiliary File. The CWF indicates the description name for an MSP code “W” record as
“WC Medicare Set-Aside.
The CWF accepts a contractor number 11119 on incoming MSP “W” HUSP records for
application on the MSP Auxiliary file. The CWF accepts a “19” in the source code field
on both the HUSP, and HUST transactions for contractor 11119. The CWF shall accept
the “Y” validity indicator for HUSP transactions created by contractor 11119. The CWF
returns a “19” in the Source Code field of the ‘03’ response trailer.
The CWF allows contractors 11100, 11101, 11102, 11103, 11104, 11105, 11106, 11107,
11108, 11109, 11110, 11111, 11112, 11113, 11114, 11115, 11116, 11117, 11118, 11119,
11122, 11125, 11126, 11139, 11140,11141, 11142, 11143, 33333, 55555, 77777, 88888,
99999, to update, delete, change records originated or updated by contractor 11119.
CWF will create and send a transaction to the contractor’s shared systems that have
processed claims for each beneficiary when an add or change transaction is received for
contractor 11119 or from contractor 11119. The CWF uses the following address for
contractor number 11119:
WCMSA Proposal/Final Settlement
P.O. Box 138899
Oklahoma City, OK 73113-8899
The CWF applies the same MSP consistency edits for Workers’ Compensation (WC)
code “E” to MSP code “W”.
The CWF maintainer creates error code (6815). The message for this new error code
(6815) reads “WC Set-Aside exists. Medicare contractor payment not allowed”. CWF
activates this error under the following conditions:
• A MSP code “W” record is present.
• The record contains a diagnosis code related to the MSP code “W” occurrence.
The CWF ensures that error code 6815 is overridden by MACS (A/B) and MACs
(DME) with a code N or M, for claim lines or claims on which workers’ compensation
set-aside diagnosis do not apply. CWF accepts the new error code (6815) as returned on
the 08 trailer.
The CWF creates a HUSP transaction error code, SP76, to set when an incoming HUSP
transaction with MSP Code “W” is submitted and the beneficiary MSP Auxiliary file
contains an open MSP occurrence with MSP code “E” with the same effective date and
diagnosis code(s).
II. Shared Systems and MACs (A/B) and MACS (DME)
A/B MACs and DME MACs shared systems accepts MSP Code “W” to identify a
Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) for use on HUSP
records for application on the HUSP Auxiliary file. The Medicare shared systems utilizes
the description name of ‘WC Medicare Set-Aside’ for MSP code “W” records.
The shared systems:
• Utilizes contractor number “11119” on incoming MSP ‘W’ HUSP records for
application on the MSP Auxiliary file.
• Accepts contractor number 11119 and MSP code “W” and source code “19” on
the returned 03 CWF trailer.
• Accepts “19” in the source code field on the HUSP, and HUST transactions for
contractor 11119.
• Accepts a “Y” validity indicator, as well as, MSP code W for transactions created
by contractor 11119.
• Accepts and processes HUST transactions when an add, change or delete
transaction is received for contractor 11119 or from contractor 11119.
• Reflects CROWD/ report special project number ‘7019’ as Workers’
Compensation Set-Aside Arrangements.
• Accepts “19” in the header Payment Indicator field and in the detail Payment
Process Indicator field for Contractor 11119.
The MACS (A/B) and MACS (DME) and their systems continue to accept claims with
value code 15 for Part A and Insurance Code (15) for Part B and DME MAC against an
open “W” MSP Auxiliary file.
The shared systems accepts error code (6815) as returned with the 08 trailer. Following
receipt of the utilization error code 6815, the A/B MACs and DME MACs systems deny
all claims (including conditional payment claims) related to the diagnosis codes on the
CWF MSP code “W”, when there is no termination date entered for the “W” code.
Upon denying the claim, all contractor shared systems create a “19” Payment Denial
Indicator in the header of its HUIP, HUOP, HUHH, HUHC, HUBC, HUDC claims.
Upon denying the claim the MACs (B) and MACS (DME), MCS and VMS
• Populate a “W” in the MSP code field and
• Create a ‘19’ in the HUBC and HUDC claim header transaction and a ‘19’ in the
claim detail process.
Upon denying the claim MACs (A) and the FISS system
• Populate a 15 in the value code field, in addition to the requirements referenced
above.
For MSP verification purposes, and prior to overriding claims on which the A/B MAC or
DME MAC contractor received error code 6815, it shall:
• check CWF to confirm that the date of service of the claim is after the termination
date of the MSP “W” record.
• and confirm the diagnosis code on the claim is related to the diagnosis codes on
the MSP W record.
MACs (B) and MACs (DME) overrides the payable lines with override code N.
The MACs (A) override the payable claims with override code N. If a claim is to be
allowed, an ‘N’ is placed on the “001” Total revenue charge line of the claim.
The shared systems allows for an override of new error code 6815 with the code N.
The Comprehensive Error Rate Testing (CERT) contractor accepts the MSP code “W” in
the claim resolution field.
The shared systems bypasses the MSPPAY module if there is an open MSP code “W”.
The shared systems does not make payment for those services related to diagnosis codes
associated with the “W” Auxiliary record when the claims date of service is on or after
the effective date and before or on the termination date of the record.
The shared systems makes payment for those services related to the diagnosis codes
associated with the “W” auxiliary record when a terminate date is entered and the claims
date for service is after the termination date.
The shared systems includes Reason Code 201, Group Code “PR”, Remark Code N722
and “Alert” Remark Code MA01, when denying claims based on a ‘W’ MSP auxiliary
record on outbound 837 claims.
The shared systems utilize Group Code “PR”; Remark Code N722 and “Alert” Remark
Code MA01, Reason Code 201, when denying claims based on a “W” MSP auxiliary
record for 835 ERA and SPR messages.
The shared system will afford appeal rights for denied MSP code “W” claims.
III. The MACS (A/B) and MACs (DME):
• Shall not make payment for those services related to diagnosis codes associated
with an open “W” auxiliary record (not termed).
• Shall make payment for those services related to diagnosis codes associated with
a termed auxiliary “W” record when the claims date of service is after the
termination date.
The MACS (A/B) and MACs (DME) will include Reason Code 201, Group Code “PR”,
Remark Code N722 and “Alert” Remark Code MA01, when denying claims based on a
‘W’ MSP auxiliary record on outbound 837 claims.
The MACS (A/B) and MACs (DME) utilize Group Code “PR”; Remark Code N722 and
“Alert” Remark Code MA01, Reason Code 201, when denying claims based on a “W”
MSP auxiliary record for 835 ERA and SPR messages.
The MACS (A/B) and MACs (DME) and share systems shall afford appeal rights for
denied MSP code “W” claims.
Those systems responsible for the HETS 270/271 transaction shall ensure that
documentation concerning the EB value and qualifier WC is updated.
The CROWD/MDX reflects special project number “7019” as Workers’ Compensation
Medicare Set-Aside Arrangements.
IV. Medicare Residual Payment When WCMSA benefits terminate, or deplete,
during a beneficiary’s provider facility stay or upon a physician’s visit.
There are situations where WCMSA benefits may terminate, or deplete, during a
beneficiary’s provider facility stay or upon a physician’s visit and a residual Medicare
secondary payment is due. Under these circumstances Medicare may make a residual
secondary payment. The term “residual payment” is defined as: a payment Medicare
makes on a claim where available funds have been exhausted from the WCMSA benefit
or responsibility for payment terminates mid-service. The A/B MACs (A/B), DME
MACs and shared systems may pay this residual secondary payment by sending the
primary payer amounts to the MSPPAY module and calculate Medicare’s payment if
such services are covered and reimbursable by Medicare.
The MACs (A/B), MACs (DME), and shared systems, receive, accept, and make a
residual payment on MSP Type 15 (MSP Code E) WCMSA electronic claims when the
CAS segment shows one of the following CARCs and primary payer benefits are
terminated, exhausted or the claim contains a partial or zero payment:
27 – Expenses occurred after coverage terminated.
35 – Lifetime benefit maximum has been reached.
119 – Benefit maximum for this time period, or occurrence, has been reached.
149 – Lifetime benefit maximum has been reached for this source/benefit category.
The MACs (A/B), MACs (DME), and shared systems receive, accept, and make payment
on MSP Type 15, WCMSA paper (hard copy) claims when the claim includes an
attached remittance advice (RA)/Explanation of Benefits (EOB) that:
1) Shows the claim with a zero payment or was not paid in full by the primary
payer and a residual payment is due;
2) Is a Medicare covered and reimbursable service; and
3) Contains a reason code for denial or similar verbiage if a reason code is not
indicated:
• Expenses occurred after the coverage terminated;
• Lifetime benefit maximum has been reached;
• Benefit maximum for this time period, or occurrence, has been reached; or
• Lifetime benefit maximum has been reached for this source/benefit
category.
NOTE: If an MSP Type 15, WCMSA electronic, or hard copy claim, is received and
there is a corresponding WCMSA record on CWF and the claim contains a partial, or
zero, payment from a primary insurer and the claim, or attached primary payer remittance
advice/EOB, does not include a reason code for denial or similar verbiage if a reason
code is not indicated, the A/B MACs, DME MACs and shared system deny the claim
based on the CWF utilization 6815.
In order for the residual payment to occur, CWF performs the following functions:
CWF HUIP, HUOP, HUHH, HUHC (HBIP, HBOP, HBHH, and HBHC for BDS) claims
allow for a 1-byte field (Residual Payment Indicator) at the claim header level. Valid
values for the field = X or space.
CWF HUBC and HUDC (HBBC and HBDC for BDS) claims allow for a 1-byte field
(Residual Payment Indicator) at the claim header level and at the detail level. Valid
values for the field = X or space.
NOTE: The shared systems must ensure that the MACs are able to input an “X” in the
header of their claims, and at the service line level, when applicable, that are sent to
CWF, for situations when the claim is not paid, or not paid in in full, by the primary
payer.
CWF shall override the 6815 WCMSA utilization error code when the MACs determine
a residual payment should be made on the claim.
The MACs make a residual payment by placing the “X” at the header for the Part A
claims, or an ‘X’ at either the header or detail line for Part B Professional and DME
MAC claims.
The A/B MACs, DME MACs and shared systems must send the primary payer’s MSP
amounts, found on the incoming WCMSA claim, to MSPPAY for Medicare’s Secondary
Payment calculation when a residual payment is expected to be made by Medicare.
NOTE: When applicable, the A/B MACs and DME MACs send the attestation
form/letter, it received from the reporting entity indicating WCMSA benefits are
exhausted, to the MSP Contractor. For ORM, the Section 111 reporting entity shall
report that benefits are exhausted via the normal quarterly data file process.
60 - Converting Health Insurance Portability and Accountability Act
(HIPAA) Individual Relationship Codes to Common Working File
(CWF) Medicare Secondary Payer (MSP) Patient Relationship Codes
(Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23)
CMS has realized that its Common Working File (CWF) HUSP transaction does not
allow for the correct association of HIPAA individual relationship codes, as found in the
HIPAA 837 institutional and professional claims implementation guides, with
corresponding MSP Type Codes, such as working aged (A), end-stage renal disease (B),
and disability (G). Therefore, effective July 6, 2004, all A/B MACs (A) that receive
incoming electronic HIPAA, DDE, or hard copy claims that are in the HIPAA ASC X12
837 format shall convert the incoming individual relationship codes to their equivalent
CWF patient relationship codes. Until further notice, A/B MACs (A) shall continue to
operate under the working assumption that all providers will be including HIPAA
individual relationship codes on incoming claims.
Before CMS’ systems changes are effectuated, A/B MACs (A) may receive SP edits (i.e.,
SP-33 and SP-52) that indicate that an invalid patient relationship code was applied. A/B
MACs (A) are to resolve those edits by manually converting the HIPAA individual
relationship code to the CWF patient relationship code, as specified in the conversion
chart below. If the A/B MAC (A) receives MSP edits and can determine that the HIPAA
individual relationship code rather than the CWF patient relationship code was submitted
on the incoming claim, it shall manually work the MSP edits incurred by converting the
HIPAA individual relationship code to the appropriate CWF patient relationship code.
Until Part A shared system changes are effectuated to convert HIPAA individual
relationship codes to CWF patient relationship codes, A/B MACs (A) may move claims
with a systems age of 30 days or older that have suspended for resolution of patient
relationship code, including SP-33 or SP-52 edits, to condition code 15 (CC-15).
The A/B MAC (A) contractor system shall utilize the conversion charts, found below, to
cross-walk incoming HIPAA individual relationship codes to the CWF patient
relationship code values.
For MSP Occurrences with accretion dates PRIOR to 4/4/2011:
HIPAA
Individual
Relationship
Codes
Convert To CWF
Patient Relationship
Codes
Valid Values
18
01
Patient is Insured
HIPAA
Individual
Relationship
Codes
Convert To CWF
Patient Relationship
Codes
Valid Values
01
02
Spouse
19
03
Natural Child, Insured has financial
responsibility
43
04
Natural Child, insured does not have
financial responsibility
17
05
Step Child
10
06
Foster Child
15
07
Ward of the Court
20
08
Employee
21
09
Unknown
22
10
Handicapped Dependent
39
11
Organ donor
40
12
Cadaver donor
05
13
Grandchild
07
14
Niece/Nephew
41
15
Injured Plaintiff
23
16
Sponsored Dependent
24
17
Minor Dependent of a Minor
Dependent
32,33
18
Parent
04
19
Grandparent
53
20
Life Partner
29
N/A
Significant Other
30
N/A
?
31
N/A
?
36
N/A
?
G8
N/A
?
Other HIPAA
Individual
Relationship Codes
N/A
?
For MSP Occurrences with accretion dates 4/4/2011 AND SUBSEQUENT:
HIPAA
Individual
Relationship
Codes
Convert To CWF
Patient Relationship
Codes
Description
18
01
Self; Beneficiary is the policy holder
or subscriber for the other GHP
insurance reflected by the MSP
HIPAA
Individual
Relationship
Codes
Convert To CWF
Patient Relationship
Codes
Description
occurrence –or- Beneficiary is the
injured party on the Workers
Compensation, No-Fault, or Liability
claim
01
02
Spouse
19
03
Child
43
03
Child
17
03
Child
10
03
Child
15
04
Other
20
04
Other
21
04
Other
22
04
Other
39
04
Other
40
04
Other
05
04
Other
07
04
Other
41
01
Self; Beneficiary is the policy holder
or subscriber for the other GHP
insurance reflected by the MSP
occurrence –or- Beneficiary is the
injured party on the Workers
Compensation, No-Fault, or Liability
claim
23
04
Other
24
04
Other
32,33
04
Other
04
04
Other
53
20
Life Partner
29
N/A
Significant Other
30
N/A
?
31
N/A
?
36
N/A
?
G8
N/A
?
Other HIPAA
Individual
Relationship Codes
N/A
?
A/B MACs (A) allow CWF patient relationship codes, since these files should be
populated with information sent back to the A/B MACs (A)’ systems via the automated
transaction.
Transmittals Issued for this Chapter
Rev # Issue Date Subject Impl Date CR#
R12078MSP
06/14/2023
Significant Updates to Internet Only
Manual (IOM) Publication (Pub.) 100-05
Medicare Secondary Payer (MSP) Manual,
Chapter 6
05/29/2023 13160
R11996MSP
04/27/2023
Significant Updates to Internet Only
Manual (IOM) Publication (Pub.) 100-05
Medicare Secondary Payer (MSP) Manual,
Chapter 6 ) – Rescinded and replaced by
Transmittal 12078
05/29/2023
13160
R11381MSP
04/29/2022
Updating the Common Working File
(CWF) Logic Tied to Medicare Secondary
Payer (MSP) Investigational Records to
Match Newly Revised Development
Timeframes
10/03/2022
12678
R10753MSP
05/11/2021
Update the Common Working File (CWF)
to Accept a Group Health Plan (GHP) and
non-GHP (NGHP) Medicare Secondary
Payer (MSP) Effective Date 3 Months from
the Current Date for Medicare Enrolled and
Medicare Entitled Beneficiaries
10/04/2021
12176
R10243MSP
07/31/2020
Updating the Common Working File
(CWF) to allow for a Medicare Secondary
Payer (MSP) Termination Date Greater
than the Current Date Plus Six Months for
non-Group Health Plan (NGHP) MSP
Auxiliary Records
01/04/2021
11771
R125MSP 03/22/2019
Update to Publication (Pub.) 100-05 to
Provide Language-Only Changes for the
New Medicare Card Project
04/22/2019 11193
R124MSP 08/31/2018
Updates to Chapters 5 and 6 of Publication
100-05 to Further Clarify Medicare
Secondary Payer (MSP) Processes that
Include Electronic Correspondence
Referral System (ECRS) Requests
Submissions and Timely Submission of
MSP I Records, General Inquiries and
Hospital Reviews
10/01/2018 10855
R121MSP 06/01/2018
Update the International Classification of
Diseases, Tenth Revision (ICD-10) 2019
Tables in the Common Working File
(CWF) for Purposes of Processing Non-
Group Health Plan (NGHP) Medicare
Secondary Payer (MSP) Records and
Claims
10/01/2018 10803
R119MSP 04/07/2017
Implement the International Classification
of Diseases, Tenth Revision (ICD-
10) 2018
General Equivalence Mappings (GEMs)
Tables in the Common Working File
(CWF) for Purposes of Processing Non-
Group Health Plan (NGHP) Medicare
Secondary Payer (MSP) Records and
Claims
10/02/2017 9947
R114MSP 09/18/2015
Claims Processing Medicare Secondary
Payer (MSP) Policy and Procedures
Regarding Ongoing Responsibility for
Medicals (ORM)
07/06/2015 8984
R113MSP 08/06/2015
Instructions for the Shared Systems and
Medicare Administrative Contractors
(MACs) to follow when a Medicare
Residual Payment must be Paid on
Workers’ Compensation Medicare Set-
aside Arrangement (WCMSA) or for
Ongoing Responsibility of Medicals
(ORM) Non-Group Health Plan (NGHP)
Medicare Secondary Payer (MSP) Claims
01/04/2016 9009
R110MSP 03/06/2015
Claims Processing Medicare Secondary
Payer (MSP) Policy and Procedures
Regarding Ongoing Responsibility for
Medicals (ORM) –
Rescinded and replaced
by Transmittal 114
07/06/2015 8984
R107MSP 10/24/2014
Update to Pub. 100-05, Chapters 05 and 06
to Provide Language-Only Changes for
Updating ICD-10 and ASC X12
11/28/2014 8947
R95MSP 08/23/2013
Update of the Common Working File
(CWF) to not Allow Certain Diagnosis
Codes on No-Fault Medicare Secondary
Payer (MSP) Records
01/06/2014 8351
R94MSP 06/28/2013
Update the Medicare Secondary Payer
Manuals to Indicate Unsolicited Refund
Documentation is No Longer a
Justification for Submission of an “I”
Record
07/30/2013 8253
R89MSP 08/30/2012
Expanding the Coordination of Benefits
(COB) Contractor Numbers to Include
11139 and 11142 for the Common
Working File (CWF)
01/07/2013 7906
R88MSP 08/17/2012
Expanding the Coordination of Benefits
(COB) Contractor Numbers to Include
11139 and 11142 for the Common
Working File (CWF)
01/07/2013 7906
R81MSP 07/29/2011
Requesting the Common Working File
(CWF) to Cease Submitting First Claim
Development (FCD) and Trauma Code
Development (TCD) Alerts to the
Coordination of Benefits Contractor
(COBC)
01/03/2012 7483
R77MSP 01/21/2011
Categorizing Diagnosis Codes 500-
508 and
800-999 on Incoming Medicare Secondary
Payer (MSP) Claims and on the MSP
Auxiliary File for non-Group Health Plan
(GHP) Claims
07/05/2011 7149
R76MSP
11/19/2010
Common Working File (CWF) Medicare
Secondary Payer ( MSP) Coordination of
Benefits Contractor (COBC) Number
Update and Implementation of MSP Group
Health Plan (GHP) COBC Hierarchy Rules
as related to Mandatory Insurer Reporting
04/04/2011 7216
R74MSP
04/28/2010
New Medicare Secondary Payer Insurer
Type Codes
10/04/2010 6768
R65MSP 03/20/2009
New Common Working File (CWF)
Medicare Secondary Payer (MSP) Type for
Workers Compensation Medicare Set-
Aside Arrangements (WCMSAs) to Stop
Conditional Payments
04/06/2009/
07/06/2009
5371
R64MSP 01/09/2009
New Common Working File (CWF)
Medicare Secondary Payer (MSP) Type for
Workers Compensation Medicare Set-
Aside Arrangements (WCMSAs) to Stop
Conditional Payments - Rescinded and
replaced by Transmittal 65
04/06/2009/
07/06/2009
5371
R61MSP 10/03/2008
Expanding the Mandatory Insurer
Reporting (MIR) Coordination of Benefits
(COB) Contractor Numbers for the
Common Working File (CWF)
01/05/2009 6182
R60MSP 09/19/2008
Expanding the Mandatory Insurer
Reporting (MIR) Coordination of Benefits
(COB) Contractor Numbers for the
Common Working File (CWF) -
Rescinded
and replaced by Transmittal 61
01/05/2009 6182
R43MSP 10/31/2005
Expanding the Voluntary Data Sharing
Agreement (VDSA) Coordination of
Benefit (COB) Contractor Numbers for the
Common Working File (CWF)
04/03/2006 3826
R31MSP 07/08/2005
Full Replacement of CR 3770,Expanding
the Number of Source Identifiers for
Common Working File (CWF) MSP
Records
10/03/2005 3909
R12MSP 03/05/2004
Converting HIPAA Individual Relationship
Codes to Common Working File (CWF)
Patient Relationship Codes
03/19/2004 3117
R09MSP 02/06/2004
Converting Health Insurance Portability
and Accountability ct (HIPAA) Individual
Relationship Codes to Common Working
File (CWF) Patient Relationship Codes
07/06/2004 3116
R08MSP 02/06/2004
Common Working File MSP Modifications
07/06/2004 2775
R06MSP 01/162004 Automatic Notice of Change to MSP
Auxiliary File
01/01/2004 2608
R01MSP 10/01/2003
Initial Issuance of Manual N/A N/A
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