RC OID Table - CMS

Review Contractor (RC) OID TABLE

Review Contractor

RAC Region 1 (Performant) RAC Region 2 (Cotiviti) RAC Region 3 (Cotiviti) RAC Region 4 (Cotiviti) RAC Region 5 (Performant) MAC JM (Palmetto)

MAC JJ Palmetto) MAC JL (Novitas Solutions)

MAC JK (NGS)

MAC J15 (CGS) MAC JE (Noridian)

OID

urn:oid:2.16.840.1.113883.13.34.110.1.100.21 urn:oid:2.16.840.1.113883.13.34.110.1.100.22 urn:oid:2.16.840.1.113883.13.34.110.1.100.23 urn:oid:2.16.840.1.113883.13.34.110.1.100.24 urn:oid:2.16.840.1.113883.13.34.110.1.100.25 urn:oid:2.16.840.1.113883.13.34.110.1.110.11

Start Date for esMD

03/23/17 02/15/17 02/15/17 10/30/16 10/30/16 08/29/11

urn:oid:2.16.840.1.113883.13.34.110.1.110.10 08/21/11 urn:oid:2.16.840.1.113883.13.34.110.1.110.12 08/29/11

urn:oid:2.16.840.1.113883.13.34.110.1.110.13 08/29/11

urn:oid:2.16.840.1.113883.13.34.110.1.110.15 03/09/12 urn:oid:2.16.840.1.113883.13.34.110.1.110.16 09/05/13

MAC JF (Noridian)

urn:oid:2.16.840.1.113883.13.34.110.1.110.3 09/09/13

MAC J5 (WPS) MAC JH (Novitas Solutions)

urn:oid:2.16.840.1.113883.13.34.110.1.110.5 08/29/11 urn:oid:2.16.840.1.113883.13.34.110.1.110.7 10/22/12

MAC J8 (WPS) MAC JN (FCSO)

urn:oid:2.16.840.1.113883.13.34.110.1.110.8 11/15/12 urn:oid:2.16.840.1.113883.13.34.110.1.110.9 08/29/11

DME MAC A (Noridian)

urn:oid:2.16.840.1.113883.13.34.110.1.150.1 08/29/11

DME MAC B (CGS) DME MAC C (CGS) DME MAC D (Noridian)

urn:oid:2.16.840.1.113883.13.34.110.1.150.2 urn:oid:2.16.840.1.113883.13.34.110.1.150.3 urn:oid:2.16.840.1.113883.13.34.110.1.150.4

08/29/11 08/29/11 08/29/11

CERT (NCI) PERM Review Contractor (NCI) MAC J6 (NGS) SMRC (Noridian) RRB (Palmetto GBA)

QIO Appeals (Livanta) QIO Quality of Care Complaints (Livanta) QIO HWDRG (Livanta) QIO SSR (Livanta) QIC Part A East (C2C)

QIC Part A West (Maximus) QIC Part B North (C2C) QIC Part B South (C2C) QIC DME (Maximus) UPIC NE (Safeguard Services) UPIC MW (Covent Bridge Group) UPIC SW (Qlarant) UPIC SE (Safeguard Services) UPIC W (Qlarant)

urn:oid:2.16.840.1.113883.13.34.110.1.200.1 urn:oid:2.16.840.1.113883.13.34.110.1.200.3 urn:oid:2.16.840.1.113883.13.34.110.1.250.1 urn:oid:2.16.840.1.113883.13.34.110.1.250.2 urn:oid:2.16.840.1.113883.13.34.110.1.400.1 urn:oid:2.16.840.1.113883.13.34.110.1.500.12 urn:oid:2.16.840.1.113883.13.34.110.1.500.13

10/07/16 09/17/18 11/26/12 05/23/18 10/27/14 10/19/20 10/19/20

urn:oid:2.16.840.1.113883.13.34.110.1.500.15 urn:oid:2.16.840.1.113883.13.34.110.1.500.17 urn:oid:2.16.840.1.113883.13.34.110.1.600.1 urn:oid:2.16.840.1.113883.13.34.110.1.600.2 urn:oid:2.16.840.1.113883.13.34.110.1.600.3 urn:oid:2.16.840.1.113883.13.34.110.1.600.4 urn:oid:2.16.840.1.113883.13.34.110.1.600.6 urn:oid:2.16.840.1.113883.13.34.110.1.700.1 urn:oid:2.16.840.1.113883.13.34.110.1.700.6

10/19/20 10/19/20 02/15/17 04/03/17 07/01/16 07/01/16 09/01/19 02/23/17 01/18/21

urn:oid:2.16.840.1.113883.13.34.110.1.700.3 urn:oid:2.16.840.1.113883.13.34.110.1.700.4 urn:oid:2.16.840.1.113883.13.34.110.1.700.5

04/01/18 06/01/18 05/01/18

Note: OIDs for both Validation and Production environment are same

Content Type Code

1, 1.6, 11 1, 1.6, 11 1, 1.6, 11 1, 1.6, 7, 11 1, 1.6, 11 1, 1.5, 1.6, 7, 8.1, 8.3, 8.5, 9, 13, 15.1, 15.2, 15.3 1, 1.5, 1.6, 7, 8.1, 8.5, 9 1, 1.5, 1.6, 7, 8.1, 8.5, 9, 13, 15.1, 15.2, 15.3 1, 1.5, 1.6, 7, 8.5, 9, 15.1, 15.2, 15.3 1, 1.5, 1.6, 7, 8.5, 9, 13 1, 1.5, 1.6, 7, 8.5, 9, 15.1, 15.2, 15.3 1, 1.5, 1.6, 7, 8.5, 9, 15.1, 15.2, 15.3 1, 1.5, 1.6, 7, 8.1, 8.5, 9 1, 1.5, 1.6, 7, 8.1, 8.5, 9, 15.1, 15.2, 15.3 1, 1.5, 1.6, 7, 8.1, 8.5, 9, 13 1, 1.5, 1.6, 7, 8.1, 8.5, 9, 15.1, 15.2, 15.3 1, 1.5, 1.6, 7, 8.4, 9, 9.1, 10, 13, 15.1, 15.2, 15.3

1, 1.5, 1.6, 7, 8.4, 9, 10, 13 1, 1.5, 1.6, 7, 8.4, 9, 10, 13 1, 1.5, 1.6, 7, 8.4, 9, 10, 13, 15.1, 15.2, 15.3 1 1 1, 1.5, 1.6, 8.5, 9, 15.1, 15.2, 15.3 1, 1.6 1, 1.6, 9, 15.1, 15.2, 15.3

1 1

1 1 9.1

9.1 9.1 9.1 9.1, 11.1 1 1

1 1 1

Updated June 09, 2022

Legend:

Content Type Code (CTC) 1 1.3 1.4 1.5 1.6 5 7 8.1 8.3 8.4 8.5 9 9.1 10 11 11.1 13 15.1, 15.2, 15.3

Business Type

Response to Additional documentation request (ADR) Review Results Letters PA/PCR Decision Letters Pre-Pay Electronic Medical Documentation Request (eMDR) letters Post-Pay Electronic Medical Documentation Request (eMDR) letters Service Registrations Unsolicited PWK Documentation Ambulance Transport Home Health Pre-Claim Review (HHPCR) PA Durable Medical Equipment, Prosthetics/Orthotics & Supplies (DMEPOS) PA Hospital Outpatient Department Services (HOPD) PA First Level Appeal Requests Second Level Appeal Requests Advanced Determination of Medicare Coverage (ADMC) RA Discussion Requests DME Discussion Request XDR X12 Internal Contractor Document Transfer (ICDT)

Updated June 09, 2022

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