> ## Documentation Index
> Fetch the complete documentation index at: https://mso.getlemma.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Further reading & primary sources

> Curated primary sources: code lists, CMS manuals, state board indexes, and the benchmark data worth knowing about.

Where to go for the authoritative version. This site cites these; you should be able to reach them directly.

## Code sets and transaction standards

| Source                                                                                                       | What it is                                             |
| ------------------------------------------------------------------------------------------------------------ | ------------------------------------------------------ |
| [ASC X12](https://x12.org/)                                                                                  | The standards body. Transaction implementation guides. |
| [X12 Claim Adjustment Reason Codes](https://x12.org/codes/claim-adjustment-reason-codes)                     | **The authoritative CARC list**                        |
| [X12 Remittance Advice Remark Codes](https://x12.org/codes/remittance-advice-remark-codes)                   | **The authoritative RARC list**                        |
| [NUCC Provider Taxonomy](https://www.nucc.org/index.php/code-sets-mainmenu-41/provider-taxonomy-mainmenu-40) | The taxonomy code set, updated twice yearly            |
| [CMS Place of Service Codes](https://www.cms.gov/medicare/coding-billing/place-of-service-codes/code-sets)   | The POS code set                                       |
| [CMS HCPCS](https://www.cms.gov/medicare/coding-billing/healthcare-common-procedure-system)                  | HCPCS Level II                                         |
| [CDC ICD-10-CM](https://www.cdc.gov/nchs/icd/icd-10-cm/)                                                     | Diagnosis codes, updated October 1                     |
| [AMA CPT](https://www.ama-assn.org/practice-management/cpt)                                                  | CPT, licensed                                          |
| [ADA CDT](https://www.ada.org/publications/cdt)                                                              | CDT, licensed                                          |
| [CMS NCCI Edits](https://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits)  | Code-pair edits                                        |

## CMS

| Source                                                                                                                 | Use                                                                                                                                   |
| ---------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------- |
| [CMS Internet-Only Manuals](https://www.cms.gov/regulations-and-guidance/guidance/manuals/internet-only-manuals-ioms)  | The manual set. The chapters that matter most: **Claims Processing Manual** (Pub. 100-04) and **Benefit Policy Manual** (Pub. 100-02) |
| [Medicare Physician Fee Schedule](https://www.cms.gov/medicare/payment/fee-schedules/physician)                        | Rates, RVUs, and the annual conversion factor                                                                                         |
| [PECOS](https://pecos.cms.hhs.gov/)                                                                                    | Medicare enrollment                                                                                                                   |
| [Medicare Revalidation Lookup](https://data.cms.gov/tools/medicare-revalidation-list)                                  | **Check your revalidation date directly**                                                                                             |
| [Medicare Coverage Database](https://www.cms.gov/medicare-coverage-database/)                                          | LCDs and NCDs                                                                                                                         |
| [Medicare Appeals](https://www.cms.gov/medicare/appeals-grievances/fee-for-service)                                    | The five-level process                                                                                                                |
| [Administrative Simplification](https://www.cms.gov/medicare/regulations-guidance/administrative-simplification)       | Transaction standards, operating rules, EFT                                                                                           |
| [No Surprises Act](https://www.cms.gov/nosurprises)                                                                    | Balance billing and good faith estimates                                                                                              |
| [Medicaid.gov Provider Enrollment](https://www.medicaid.gov/medicaid/program-integrity/provider-enrollment/index.html) | Screening requirements                                                                                                                |

## Identifiers and credentialing

| Source                                           | Use                                            |
| ------------------------------------------------ | ---------------------------------------------- |
| [NPPES](https://nppes.cms.hhs.gov/)              | Apply for and maintain NPIs                    |
| [NPI Registry](https://npiregistry.cms.hhs.gov/) | **Look up an NPI before creating a duplicate** |
| [CAQH ProView](https://proview.caqh.org/)        | Credentialing profiles                         |
| [OIG LEIE](https://exclusions.oig.hhs.gov/)      | Exclusion screening, **monthly**               |
| [SAM.gov](https://sam.gov/)                      | Federal debarment screening                    |
| [NPDB](https://www.npdb.hrsa.gov/)               | Practitioner data bank                         |

## Compliance

| Source                                                                                                                       | Use                                              |
| ---------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------ |
| [HHS OCR HIPAA](https://www.hhs.gov/hipaa/index.html)                                                                        | Privacy, Security, and Breach Notification Rules |
| [ONC Security Risk Assessment Tool](https://www.healthit.gov/topic/privacy-security-and-hipaa/security-risk-assessment-tool) | For the required risk analysis                   |
| [HHS OIG Compliance Guidance](https://oig.hhs.gov/compliance/compliance-guidance/)                                           | Compliance program elements                      |
| [OIG Self-Disclosure](https://oig.hhs.gov/compliance/self-disclosure-info/)                                                  | Voluntary disclosure protocols                   |
| [OIG Fraud & Abuse Laws](https://oig.hhs.gov/compliance/physician-education/fraud-abuse-laws/)                               | AKS, Stark, FCA overview                         |
| [CMS Physician Self-Referral](https://www.cms.gov/medicare/regulations-guidance/physician-self-referral)                     | Stark                                            |
| [SAMHSA 42 CFR Part 2](https://www.samhsa.gov/about-us/who-we-are/laws-regulations/confidentiality-regulations-faqs)         | SUD record confidentiality                       |
| [eCFR](https://www.ecfr.gov/)                                                                                                | Current CFR text                                 |

## Legal research

| Source                                                 | Use                                                              |
| ------------------------------------------------------ | ---------------------------------------------------------------- |
| [CourtListener](https://www.courtlistener.com/)        | Free case law search and opinions                                |
| State legislature bill trackers                        | The primary source for pending legislation                       |
| State medical, dental, and other board sites           | License verification, board rules, and position statements       |
| State secretary of state business search               | Entity status and good standing                                  |
| [Uniform Law Commission](https://www.uniformlaws.org/) | Model acts, including the Revised Uniform Unclaimed Property Act |

**For CPOM specifically:** major healthcare law firms publish state surveys and legislative alerts that are frequently the fastest route to a current picture. Holland & Knight, Epstein Becker Green, Nixon Peabody, Benesch, Ropes & Gray, DLA Piper, and Quarles all publish regularly on this area, and this wiki cites several of them. Treat them as pointers to primary sources rather than as the authority.

## Tax and finance

| Source                                                                                                                                      | Use                                         |
| ------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------- |
| [IRS Applicable Federal Rates](https://www.irs.gov/applicable-federal-rates)                                                                | **Monthly AFRs for intercompany notes**     |
| [IRS EIN application](https://www.irs.gov/businesses/small-businesses-self-employed/apply-for-an-employer-identification-number-ein-online) | Free, same-day                              |
| [FASB Codification](https://asc.fasb.org/)                                                                                                  | ASC 810 consolidation                       |
| [unclaimed.org (NAUPA)](https://unclaimed.org/)                                                                                             | **State unclaimed property administrators** |

## Payment and banking

| Source                                                                         | Use                                                                |
| ------------------------------------------------------------------------------ | ------------------------------------------------------------------ |
| [Nacha](https://www.nacha.org/)                                                | ACH rules                                                          |
| [The Clearing House RTP](https://www.theclearinghouse.org/payment-systems/rtp) | Real-time payments                                                 |
| [FedNow](https://www.frbservices.org/financial-services/fednow)                | Federal Reserve instant payments                                   |
| [PCI Security Standards Council](https://www.pcisecuritystandards.org/)        | PCI DSS                                                            |
| Visa and Mastercard rules                                                      | Dispute reason codes and monitoring thresholds, via your processor |

## Benchmarks and industry data

| Source                                                                                        | Use                                                                             |
| --------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------- |
| [MGMA](https://www.mgma.com/)                                                                 | Physician compensation and practice operations benchmarks                       |
| [AAPC](https://www.aapc.com/)                                                                 | Coding and billing certification and resources                                  |
| [AHIMA](https://www.ahima.org/)                                                               | Health information management                                                   |
| [HFMA](https://www.hfma.org/)                                                                 | Revenue cycle benchmarks and certification                                      |
| [ADA Health Policy Institute](https://www.ada.org/resources/research/health-policy-institute) | Dental practice data                                                            |
| [KFF](https://www.kff.org/)                                                                   | Health coverage and market data, including employer survey data on self-funding |
| [AHA](https://www.aha.org/)                                                                   | Hospital and health system data                                                 |

**Compensation and productivity benchmark data is licensed.** MGMA, SullivanCotter, and similar surveys require a subscription or purchase. If you need an FMV-defensible benchmark for a compensation arrangement, budget for the actual data rather than relying on secondary summaries.

## Payer sources

Each payer publishes its own provider manual, medical policies, companion guides, and fee schedule terms. These are the authoritative source for anything payer-specific, and they outrank any third-party summary, including this one.

See [Payer enrollment and submission links](/reference/payers/enrollment-links) for the index.


## Related topics

- [Glossary](/reference/appendix/glossary.md)
- [How we keep this current](/reference/appendix/how-we-keep-this-current.md)
