Claim Adjustment Reason Code (CARC), Remittance Advice Remark Code (RARC), and Medicare Remit Easy Print (MREP) Update
These updates are effective October 1, 2009.
Tuesday, November 24, 2009
New Codes - CARC
| 231 |
Mutually exclusive procedures cannot be done in the same day/setting. |
1/1/2010 |
Modified Codes - CARC
| 40 |
Charges do not meet qualifications for emergent/urgent care. |
04/01/2010 |
| 50 |
These are non-covered services because this is not deemed a 'medical necessity' by the payer. |
4/1/2010 |
| 55 |
Procedure/treatment is deemed experimental/investigational by the payer. |
4/1/2010 |
| 56 |
Procedure/treatment has not been deemed 'proven to be effective' by the payer. |
4/1/2010 |
| 58 |
Treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service. |
4/1/2010 |
| 59 |
Processed based on multiple or concurrent procedure rules. (For example multiple surgery or diagnostic imaging, concurrent anesthesia.) |
4/1/2010 |
Deactivated Codes - CARC
| 156 * |
Flexible spending account payments. Note: Use code 187. |
10/1/2009 |
New Codes - RARC:
| N519 |
Invalid combination of HCPCS modifiers. |
NO |
| N520 |
Alert: Payment made from a Consumer Spending Account. |
NO |
CMS
Additional Information:
Source
Tuesday, November 24, 2009
