MN-Specific Rules & 42 CFR Part 2
42 CFR Part 2 / NTE Requirement
Federal regulations under 42 CFR Part 2 require that when protected substance use disorder (SUD) information is disclosed for payment purposes, claims must include a confidentiality notice.
CMS-1500: Add the required notice text to Box 19 (Loop 2300 REF*9F / NTE segment).
UB-04: Add the required notice text to Box 80.
These fields have an 80-character limit. The standard required language exceeds 80 characters, so you will need to work with your payer to agree on an acceptable abbreviated version.
A commonly used short form is: 42 CFR PART 2 PROHIBITS UNAUTHORIZED USE/DISCLOSURE TPO ON FILE
This is a regulatory requirement — it must be entered manually for now. Ritten is working on automation options for a future release.
MN Medicaid H2036 Configuration
For H2036 codes billed to MN government payers, enable both bundling and consolidation on the service rule. All relevant encounters for a single date of service will be consolidated into one claim, with all services on one claim line.
MN Medicaid Calendar Month Split
Use the calendar month claim split setting (available as a service rule output or override) to automatically split claims when services span a calendar month boundary. This is required for MN Medicaid and other payers that require one claim per calendar month.
MN Medicaid "In and Out" ERA Behavior
MN Medicaid sometimes sends remittances with both payments and clawbacks on the same ERA. Applying these automatically can incorrectly flip claim status to Paid. Review MN Medicaid ERAs line by line rather than using auto-post.