The following changes to the remittance advice remark codes and claim adjustment reason codes will be effective July 1, 2009.
New Codes – CARC:
| Code |
Current Narrative |
Effective Date per WPC Posting |
| 229 |
Partial charge amount not considered by Medicare due to the initial claim Type of Bill being 12X. Note: This code can only be used in the 837 transaction to convey Coordination of Benefits information when the secondary payer’s cost avoidance policy allows providers to bypass claim submission to a prior payer. Use Group Code PR. |
1/25/2009 |
| 230 |
No available or correlating CPT/HCPCS code to describe this service, Note: Used only by Property and Casualty |
1/25/2009 |
Modified Codes – CARC:
| Code |
Current Narrative |
Effective Date per WPC Posting |
| 187 |
Health Savings account payments. This change to be effective 10/1/2009: Consumer Spending Account payments (includes but is not limited to Flexible Spending Account, Health Savings Account, Health Reimbursement Account, etc.) |
1/25/2009 |
Deactivated Codes – CARC
| Code |
Current Narrative |
Effective Date |
| 17 |
Requested information was not provided or was insufficient/incomplete. At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code.) |
7/1/2009 |
| 156 |
Flexible spending account payments. Note: Use code 187. |
10/1/2009 |
New Codes – RARC:
| Code |
Current Narrative |
Medicare Initiated |
| N516 |
Records indicate a mismatch between the submitted NPI and EIN. |
NO |
| N517 |
Resubmit a new claim with the requested information |
YES |
Modified Codes – RARC:
| Code |
Current Narrative |
Medicare Initiated |
| N109 |
This claim/service was chosen for complex review and was denied after reviewing the medical records. Start: 02/28/2002 | Last Modified: 03/01/2009 Notes: (Modified 3/1/2009) |
Yes |
| N387 |
Alert: Submit this claim to the patient’s other insurer for potential payment of supplemental benefits. We did not forward the claim information. Start: 04/01/2007 | Last Modified: 03/01/2009 Notes: (Modified 3/1/2009) |
Yes |
Deactivated Codes – RARC:
| Code |
Current Narrative |
Medicare Initiated |
| N515 |
Alert: Submit this claim to the patient’s other insurer for potential payment of supplemental benefits. We did not forward the claim information (use N387 instead). Start: 11/01/2008 | Stop: 10/01/2009 |
Yes |
