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TRICARE Systems Manual 7950.3-M, April 1, 2015
April 1, 2015
Revision:  C-14, May 30, 2018
The TRICARE Systems Manual (TSM), 7950.3-M, defines the contractor’s responsibilities for automated processing of health care information, reporting and transmission of relevant data between the contractor and the Defense Health Agency (DHA). The manual provides the requirements for the contractors to interface with the Defense Enrollment Eligibility Reporting System (DEERS) for obtaining beneficiary eligibility verifications from DEERS and performing TRICARE Prime enrollments onto DEERS, as well as TRICARE Encounter Data reporting requirements.
The Department of Defense (DoD) has a License Agreement with the American Medical Association (AMA) regarding the use of the Physician’s Current Procedural Terminology (CPT), a coding work of medical nomenclature developed by the AMA. In accordance with the terms of that Agreement, the DoD has agreed to:
Include a Copyright notice in every section that references CPT codes;
Specifically identify procedure codes as CPT procedure codes;
Use only short descriptions with CPT codes and delete all long descriptions; and
Italicize short descriptions wherever they are used.
The TRICARE Manuals provide instructions, guidance and responsibilities in addition to the requirements set forth in the incorporated federal statutes and the regulations and may not be interpreted in contradiction thereto.
Digital signature of Section Chief (or designee) of Health Plan Operations Sections (HPOS), Defense Health Agency (DHA).
John L. Arendale, Branch Chief
Health Plan Operations Branch (HPOB)
Defense Health Agency (DHA)
Definitions are available in the Apr 2015 TRICARE Operations Manual (TOM), Appendix A.
Links from the documents contained within this manual (and placed on the TRICARE Manuals web site) may include links providing direct access to other Internet resources, including web sites. Because of the dynamic nature of the Internet, Defense Health Agency (DHA) cannot be responsible for the accuracy of or content of information contained in the links to other web sites.
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