US · guidance
CMS Pub. 100-01, ch. 7, § 60.1
CMS Standard File for Reason Codes
The A/B MAC (A) or (HHH) Edits Evaluation Workgroup is tasked with identifying the
inventory of contractor inactivated edits, documenting the reasons why the edits are turned off,
and making a decision as to whether they should remain inactive or not. Transmittal 338,
(Change Request (CR) 5927) issued on May 2, 2008, created the ‘CMS Standard’ field within
the existing FISS Reason Code File which contains the status that was determined by the A/B
MAC (A) or (HHH) Edits Evaluation Workgroup for each individual code that was reviewed.
The ‘CMS Standard’ field indicators are as follows:
• ‘A’ = Active
• ‘I’ = Inactive
• ‘ ‘ = Blank
NOTE: The terms ‘Active’ & ‘Inactive‘ are defined as:
• Active = Reason code status is equal to ‘S’, ‘P’, ‘ ‘ (blank), ‘D’, ‘R’, ‘T’, or is not
equal to ‘S MDLTD’; and
• Inactive = Reason code status is equal to ‘A’ or is equal to ‘S MDLTD.’
Each quarter, as necessary, CMS will issue an updated CMS Standard File for Reason Codes
which is loaded into the system by the FISS maintainer via a Recurring Update Notification.
History
(Rev. 59, Issued: 10-30-09, Effective: 04-01-10, Implementation: 04-05-10)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
9139ace526c78a843a4abdf8c0cb31398826410c16d1868300785909bb3bc724
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