Revision History Date Version Description Author 12/1/2012 3.0 Administrative Bulletin 12-01; issued 11/8/2012 M. Prettenhofer 1/28/2013 3.1 Updated Resident’ section H. ‘Non-Massachusetts DC067 (APCD ID Code): Added option (6) ICO - Integrated Care Organization 5/31/2013 3.1 Updated DC043 and DC058 Street Address to K. Hines – – a length of 50 Updated HD009 to reflect reporting period change Updated element submission guideline for Delegated Benefit Adminstrator OrganizationID (DC025). 10/2014 4.0 Administrative Bulletin 14-08 K. Hines 2/2016 5.0 Administrative Bulletin 16-03 K. Hines 2/2016 5.0 Update Cover Sheet, CHIA website and address K. Hines 2/2016 5.0 Update APCD Version Number HD009 to 5.0 K. Hines – – Table of Contents
Revision History Date Version Description Author 12/1/2012 3.0 Administrative Bulletin 12-01; issued 11/8/2012 M. Prettenhofer 1/28/2013 3.1 Updated ‘Non-Massachusetts Resident’ section DC067 (APCD ID Code): Added option (6) ICO - Integrated Care Organization H. 5/31/2013 3.1 Updated DC043 and DC058 – Street Address – to a length of 50 Updated HD009 to reflect reporting period change Updated element submission guideline for Delegated Benefit Adminstrator OrganizationID (DC025). K. Hines 10/2014 4.0 Administrative Bulletin 14-08 K. Hines 2/2016 5.0 Administrative Bulletin 16-03 K. Hines 2/2016 5.0 Update Cover Sheet, CHIA website and address K. Hines 2/2016 5.0 Update APCD Version Number – HD009 – to 5.0 K. Hines Table of Contents
v6-apcd-dental-claim-file-submission-guide-Redline-.docx