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Medical Coding News Archives

CMS Updates Remittance Advice Remark Codes

 
November 25, 2008:

The latest update to the remittance advice remark codes (RARC) includes four new codes, one deactivated code, and one modified code. The update is effective January 5th. 

The RARC list is updated three times a year—in early March, July, and November. These codes are maintained by the RARC Committee. This committee meets every month and has established the following schedule:
Request received in October—January:

  • Published in early March.
  • Deactivation becomes effective October
  • Any new code or modification become effective when published

Request received in February—May:

  • Published in early July
  • Deactivation becomes effective January
  • Any new code or modification becomes effective when published

Request received in June—September:

  • Published in early November
  • Deactivation becomes effective April
  • Any new code or any modification becomes effective when published

With this update the committee has deactivated one code: 

D22 Reimbursement was adjusted for the reasons to be provided in separate correspondence. (Note: To be used for workers' compensation only)—Temporary code to be added for timeframe only until 01/01/2009. Another code to be established and/or for 06/2008 meeting for a revised code to replace or strategy to use another existing code

Four new codes were added.

222 Exceeds the contracted maximum number of hours/days/units by this provider for this period. This is not patient specific.
Start date: 6/1/2008
223

Adjustment code for mandated federal, state or local law/regulation that is not already covered by another code and is mandated before a new code can be created.
Start date: 6/1/2008

224

Patient identification compromised by identity theft. Identity verification required for processing this and future claims.
Start date: 6/1/2008

225

Penalty or interest payment by payer (Only used for plan to plan encounter reporting within the 837)
Start date: 6/1/2008

One code was modified

60 Charges for outpatient services with this proximity to inpatient services are not covered. This change to be effective 1/1/2009: Charges for outpatient services are not covered when performed within a period of time prior to or after inpatient services.

All payers, not only CMS, use these codes to inform providers via the remittance advice of changes or modifications that affect claim processing, adjudication, and payment. 

Deborah C. Hall
Clinical/Technical Editor

 

 
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