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Implement Operating Rules – Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark…

This new Article comprises Subregulatory Guidance for updates on CAQH CORE. The next version of the Code Combination List will be published on or about October 1, 2021. CAQH CORE bases the updates on the market-based review it conducts once every 2 years to fit in code combinations that Medicare and other health plans are now using, as the industry requires. MLN Matters (MM) Articles are based on information contained within Change Requests (CRs). In this case, this article is based on content within CR12428 that is posted on the CMS website at https://www.cms.gov/files/document/r10967CP.pdf.

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Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: September 08, 2021

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.