MedicaidAdministrativeMedium impact
HIPPA - Related Code Lists
Missouri Medicaid (MO HealthNet)·MO·Provider Notice
Effective date
Apr 7, 2014
We identified it
Jun 20, 2026
Summary
MO HealthNet has transitioned from using proprietary explanation codes to standardized HIPAA-compliant code sets on claim confirmation reports and remittance advices. Providers must now reference national standard codes (Claim Adjustment Reason Codes, Remittance Advice Remark Codes, and NCPDP reject codes) through Washington Publishing Company's HIPAA-Related Code Lists website.
Action Required
Immediately: Billing team should bookmark Washington Publishing Company's HIPAA-Related Code Lists website for interpreting claim denials and remittance advice codes. Update staff training materials to reference national standard code explanations instead of MO HealthNet-specific codes. Review Section 17 (Claims Disposition) in provider manuals for detailed code information.