Crosswalk

2021 CMS 10148 Form Revisions
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2

3

4

Form

Change

Current Location

Reason

The CMS logo replaces the
Page 1 at the top of agency logo, which is the
the right hand side standard logo.
New link directs users to the
site
https://www.cms.gov/Regula
tions-andGuidance/AdministrativeSimplification/HIPAAACA/index where more
general information
Page 1 under
regarding HIPAA
The web link, http://www.cms.hhs.gov/, has been 'general questions" Administrative Simplification
section
complaints can be found.
HIPAA Administrative Simplification Complaint Form replaced.
Under the “Code Sets” subsection, the following Page 1 under
The CPT code set version is
"SELECT
updated every year. CPT-4
Current Procedural
COMPLAINT
was replaced in 2001. As of
3
TYPE(S)" Code
1/27/2021, the current CPT
Terminology
Sets
HIPAA Administrative Simplification Complaint Form CPT® codes version has been modified.
version is CPT 2021.
Grammatically incorrect.
“Select if a covered entity is
A period (.) has been added to the end of the
in violation of the following
following sentence under the “Unique Identifiers”
Unique Identifiers: National
Page 1 Page 1
subsection to make it grammatically correct:
Provider Identifier (NPI), or
under "SELECT
“Select if a covered entity is in violation of the
Employer Identification
COMPLAINT
following Unique Identifiers: National Provider
Number (EIN)." makes the
TYPE(S)" Unique phrase grammatically
Identifier (NPI), or Employer Identification
Identifiers
HIPAA Administrative Simplification Complaint Form Number (EIN)
correct.
Removal of Office of Information Technology
HIPAA Administrative Simplification Complaint Form (OIT) logo and replaced with the CMS logo.

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2021 CMS 10148 Form Revisions
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Form

Change

Under the “Operating Rules” subsection, CAQHCORE’s weblink
https://www.caqh.org/core/operating-rules has
been added, where the Council for Affordable
Quality Healthcare, Inc. (CAQH®) Committee on
Operating Rules for Information Exchange®
HIPAA Administrative Simplification Complaint Form (CORE®) operating rules are found.

Current Location

Page 1 under
"SELECT
COMPLAINT
TYPE(S)"
Operating Rules

Reason
Edifecs, a CORE-authorized
testing vendor, is providing
the updated testing platform
that supports Health
Insurance Portability and
Accountability Act (HIPAA)
Version 5010 transactions
and associated errata
(v5010) operating rules and
related test suites were
developed under CORE.

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2021 CMS 10148 Form Revisions
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7

Form

Change

Current Location

Reason

The revision makes the
statement more
understandable to the
reader. Further, the phrase
“If you select yes, please
note CMS will not share
information with the Filed
Against Entity (FAE) during
the investigation process.
However, information
provided in this complaint is
subject to rules and policy
under Freedom of
Investigation Act (FOIA).”
has been changed to “If you
select yes, CMS will not
share your information with
the Filed against Entity
(FAE) during the
investigation process.
However, information
provided in this complaint is
subject to rules and policies
under the Freedom of
Information Act (FOIA).”
The “Do you want to remain anonymous?”
Page 2 under
This provides the Freedom
question was revised to “Would you like to
"COMPLAINANT
of Information Act
DETAILS"
disclosure.
HIPAA Administrative Simplification Complaint Form remain anonymous?”
Grammatically incorrect.
"Non-Compliant HIPAA
Transaction Received (i.e.
A period (.) has been added to the first complaint
You received a nondetail example. “Non-Compliant HIPAA
compliant HIPAA
Page 5 under
Transaction Received - You received a nontransaction from a covered
"Complaint Details - entity.)" makes the phrase
compliant HIPAA transaction from a covered
grammatically correct.
Description"
HIPAA Administrative Simplification Complaint Form entity"

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2021 CMS 10148 Form Revisions
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9

Form

Change

The following question was added to the
“Complaint Details” section under “Complaint
Description”: “Does the complaint relate to the
FAE charging fees to conduct standard
HIPAA Administrative Simplification Complaint Form transactions?”
The word “referals” under the “Complaint Types”
“Transaction Section” has been corrected to
HIPAA Administrative Simplification Complaint Form “referrals”

Current Location

Reason

Page 5 under
Responses will be used to
"Complaint Details - accurately report complaint
categories.
Description"
Page 6, #9

Spelling error

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