BILLING NEWS

Claim Adjustment Reason Code (CARC), Remittance Advice Remark Code (RARC), and Medicare Remit Easy Print (MREP) Update

New Codes - CARC

Code Current Narrative Effective Date (per WPC posting)
231 Mutually exclusive procedures cannot be done in the same day/setting. 1/1/2010

Modified Codes - CARC

Code Current Narrative Effective Date (per WPC posting)
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

Code Current Narrative Effective Date
156 * Flexible spending account payments. Note: Use code 187. 10/1/2009

New Codes - RARC:

Code Current Narrative Medicare Initiated
N519 Invalid combination of HCPCS modifiers. NO
N520 Alert: Payment made from a Consumer Spending Account. NO

SOURCE: Source
INDUSTRY NEWS TAGS: CMS


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