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Process 5010 Professional Medicare Secondary Payer (MSP) and Paper Claims Where Claim Adjustment Reason Code (CARC) Amounts Appear at the Claim Level and Not at the Detail Line

This CR instructs the Part B shared systems to use the claim level amounts
to determine Medicare’s secondary payment. This involves determining the MSP amounts utilizing the CAS
adjustments, as instructed in previous MSP and MSP CARC change requests, and then send these amounts,
along with the claim detail information, to MSPPAY so MSPPAY can apportion the MSP amounts to the
detail.

Download the Guidance Document

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

Issue Date: October 29, 2010

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.