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Reason for
Change
Type of
Change
2019 30 day
document
2019 60 day
document
ODR Reporting Format containing only
letters.
Each section inlcudes both numeric and alpha
listing.
Provide clarification in response to 60 day comments.
No change
Organization Determination (OD) - Data
Element D - Number of Organization
Determinations submitted by
Enrollee/Representative (Services)
OD - Subsection #1 - Data Element D - Number of Update Provide clarification in response to 60 day comments.
ODs requested by enrollee/representative or
provider on behalf of the enrollee (Services)
No change
OD Data Element F - Number of
Organization Determinations submitted by
Provider (Services)
OD - Subsection #1, Data Element F - Number of
ODs requested by non-contract provider.
Update
Provide clarification in response to 60 day comments.
No change
OD Data Element G - Number of
Organization Determinations submitted by
Provider (claims)
OD, Subsection #1, Data Element G - Number of
Organization Determinations submitted by noncontract provider
Update
Provide clarification in response to 60 day comments.
No change
Disposition - All Organization
Determinations (OD) - Data Element A. Number of Organization Determinations –
Fully Favorable (Services) – Contract
Provider
Disposition - All ODs - Data Element B Number of Organization Determinations –
Fully Favorable (Services) – Non-contract
Provider
Update Provide clarification in response to 60 day comments.
Disposition - All ODs - Subsection #2 Data
Element A - Number of Organization
Determinations – Fully Favorable (Services)
requested by enrollee/representative or provider
on behalf of the enrollee
Disposition - All ODs - Subsection #2 Data Element Update Provide clarification in response to 60 day comments.
B. Number of Organization Determinations – Fully
Favorable (Services) requested by non-contract
provider
No change
Disposition All ODs - Data Element C Disposition - All ODs - Subsection #2 - Data
Number of Organization Determinations – Element C - Number of Organization
Fully Favorable (Claims) – Contract Provider Determinations – Fully Favorable (Claims)
submitted by enrollee/representative
Update
Update
Provide clarification in response to 60 day comments.
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
No change
No change
Disposition All ODs - Data Element D Number of Organization Determinations –
Fully Favorable (Claims) – Non-contract
Provider
Disposition - All ODs - Subsection #2 - Data
Element D - Number of Organization
Determinations – Fully Favorable (Claims)
submitted by Non-contract Provider
Update
Provide clarification in response to 60 day comments.
No change
Update Provide clarification in response to 60 day comments.
Disposition - All ODs - Subsection #2 - Data
Element E - Number of Organization
Determinations – Partially Favorable (Services)
requested by enrollee/representative or provider
on behalf of the enrollee
Update Provide clarification in response to 60 day comments.
Disposition All ODs - Data Element F Disposition - All ODs - Subsection #2 - Data
Number of Organization Determinations – Element F - Number of Organization
Partially Favorable (Services) – Non-contract Determinations – Partially Favorable (Services)
requested by non-contract provider.
Provider
No change
Disposition - All ODs - Data Element G Number of Organization Determinations –
Partially Favorable (Claims) – Contract
Provider
OD Disposition - All ODs - Subsection #2 - Data
Element G - Number of Organization
Determinations – Partially Favorable (Claims)
submitted by enrollee/representative
Update
Provide clarification in response to 60 day comments.
No change
Disposition - All ODs - Data Element H Number of Organization Determinations –
Partially Favorable (Claims) – Non-Contract
Provider
Disposition - All ODs - Subsection #2 - Data
Element H - Number of Organization
Determinations - Partially Favorable (Claims)
submitted by non-contract provider.
Update
Provide clarification in response to 60 day comments.
No change
Update Provide clarification in response to 60 day comments.
Disposition - All ODs- subsection #2 - Data
Element I - Number of Organization
Determinations – Adverse (Services) requested by
enrollee/representative or provider on behalf of
the enrollee.
Disposition - All ODs - Data Element J Disposition - All ODs - Subsection #2 Data Element Update Provide clarification in response to 60 day comments.
Number of Organization Determinations – J - Number of Organization Determinations –
Adverse (Services) – Non-contract Provider Adverse (Services) requested by non-contract
Provider
No change
Disposition - All ODs - Data Element K Number of Organization Determinations –
Adverse (Claims) – Contract Provider
No change
Disposition - All ODs - Data Element E Number of Organization Determinations –
Partially Favorable (Services) – Contract
Provider
Disposition - All ODs - Data Element I Number of Organization Determinations –
Adverse (Services) – Contract Provider
Disposition - All ODs - Subsection #2 Data Element Update Provide clarification in response to 60 day comments.
K - Number of Organization Determinations –
Adverse (Claims) submitted by
enrollee/representative
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
No change
No change
Dispostion- All ODs - Data Element L Number of Organization Determinations –
Adverse (Claims) – Non-contract Provider
Disposition - All ODs - Subsection # 2 - Data
Element L - Number of Organization
Determinations – Adverse (Claims) submitted by
non-contract provider.
Update
Provide clarification in response to 60 day comments.
No change
Reconsiderations - Data Element D Number of Reconsiderations submitted by
Enrollee/Representative (Services)
Reconsiderations - Subsection #3 - Data Element
D - Number of Reconsiderations requested by or
on behalf of enrollee (services)
Update
Provide clarification in response to 60 day comments.
No change
Reconsiderations - Data Element F - Number Reconsiderations - Subsection #3 - Data Element F Update Provide clarification in response to 60 day comments.
of Reconsiderations submitted by provider - Number of Reconsiderations requested by non(services)
contract provider (services).
No change
Reconsiderations - Data Element G Number of Reconsiderations submitted by
Provider (Claims)
Reconsiderations - Subsection #3 - Data Element Update Provide clarification in response to 60 day comments.
G - Number of Reconsiderations submitted by noncontract provider (claims)
No change
Disposition All Reconsiderations - Subsection #4 - Update Provide clarification in response to 60 day comments.
Data Element A - Number of Reconsiderations
Fully Favorable (Services) requested by
enrollee/representative or provider on behalf of
the enrollee
Disposition - All Reconsiderations - Number Disposition - All Reconsiderations - subsection #4 - Update Provide clarification in response to 60 day comments.
of Reconsiderations - Data Element B – Fully Data Element B - Number of Reconsiderations –
Fully Favorable (Services) requested by nonFavorable (Services) – Non-contract
contract provider
Provider
No change
Disposition - All Reconsiderations - Number
of Reconsiderations - Data Element C Number of Reconsiderations – Fully
Favorable (Claims) – Contract Provider
Disposition - All Reconsiderations - Subsection #4 - Update Provide clarification in response to 60 day comments.
Data Element C Number of Reconsiderations –
Fully Favorable (Claims) submitted by
enrollee/representative
No change
Disposition - All Reconsiderations - Data
Element D - Number of Reconsiderations –
Fully Favorable (Claims) – Non-contract
Provider
Disposition - All Reconsiderations - Subsection #4 Update Provide clarification in response to 60 day comments.
Data Element D - Number of Reconsiderations
Fully Favorable (Claims) submitted by noncontract provider
No change
Disposition - All Reconsiderations - Data
Element A - Number of Reconsiderations –
Fully Favorable (Services) – Contract
Provider
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
No change
Disposition - All Reconsiderations - Data
Disposition - All Reconsiderations - Number of
Element E - Number of Reconsiderations - Reconsiderations – Subsection #4 - Data Element
Partially Favorable (Services) - Contract
E - Partially Favorable (Services) requested by
provider
enrollee/representative or provider on behalf of
the enrollee
Disposition - All Reconsiderations - Data
Disposition - All Reconsiderations - Number of
Element F - Number of Reconsiderations – Reconsiderations – Subsection #4 - Data Element
Partially Favorable (Services) – Non-contract F - Number of Reconsiderations – Partially
Favorable (Services) requested by non-contract
Provider
provider
Disposition - All Reconsiderations - Data
Disposition - All Reconsiderations - Number of
Element G - Number of Reconsiderations – Reconsiderations – Subsection #4 - Data Element
Partially Favorable (Claims) – Contract
G - Number of Reconsiderations – Partially
Provider
Favorable (Claims)submitted by
enrollee/representative.
Disposition - All Reconsiderations - Data
Disposition - All Reconsiderations - Number of
Element H - Number of Reconsiderations – Reconsiderations – Subsection #4 - Data Element
Partially Favorable (Claims) – Non-contract H - Number of Reconsiderations – Partially
Provider
Favorable (Claims) submitted by non-contract
provider.
Disposition - All Reconsiderations - Data
Disposition - All Reconsiderations - Subsection #4 Element I - Number of Reconsiderations – Data Element I - Number of Reconsiderations –
Adverse (Services) – Contract Provider
Adverse (Services) requested by
enrolle/representative or provider on behalf of
the enrollee
Disposition - All Reconsiderations - Number Disposition - All Reconsiderations - Number of
Reconsiderations – Subsection #4 - Data Element J
of Reconsiderations – Data Element J Number of Reconsiderations – Adverse
- Number of Reconsiderations – Adverse
(Services) – Non-contract Provider
(Services) requested by non-contract provider
Update
Provide clarification in response to 60 day comments.
No change
Update
Provide clarification in response to 60 day comments.
No change
Update
Provide clarification in response to 60 day comments.
No change
Update
Provide clarification in response to 60 day comments.
No change
Update
Provide clarification in response to 60 day comments.
No change
Update
Provide clarification in response to 60 day comments.
No change
Disposition - All Reconsiderations - Data
Element K - Number of Reconsiderations –
Adverse (Claims) - Contract Provider
Update Provide clarification in response to 60 day comments.
Disposition - All Reconsiderations - Number of
Reconsiderations – Subsection #4 - Data Element
K - Number of Reconsiderations – Adverse
(Claims) submitted by enrollee/representative
No change
Disposition - All Reconsiderations - Data
Element L - Number of Reconsiderations –
Adverse (Claims) – Non-contract provider
Disposition - All Reconsiderations - Subsection #4 - Update Provide clarification in response to 60 day comments.
Data Element L - Number of Reconsiderations –
Adverse (Claims) submitted by non-contract
provider
No change
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
| File Type | application/pdf |
| File Title | 30 day crosswalk for Part CD Reporting Requirements |
| Subject | 30 day crosswalk for Part CD Reporting Requirements |
| Author | CMS |
| File Modified | 2018-07-02 |
| File Created | 2018-07-02 |