Reason Code Narrative

No response to a medical records request- This is a RAC determination

Common Reason Code Errors

• No response to a medical records request.
• Documentation requested was not received or was not received timely.

Common Reason Code Corrections

• Review your Recovery Auditor Contractor (RAC) findings letter and respond to medical records request timely.
• Review National Coverage Determination (NCD) and the Local Coverage Determination (LCD) as applicable.
• A Redetermination may be submitted if provider feels that sending in documentation will support need for service(s). The redetermination should include:
  • All applicable supporting medical documentation
  • Corrected UB-04 claim form
• Direct Data Entry (DDE) users can view remarks section for additional clarification.

Resources

• Remittance Advice Remark Codes
• Welcome to RAC Info! (cotiviti.com) -Review the ‘New Issues’ section.