Implement Operating Rules - Phase III ERA EFT: CORE 360 Uniform Use of CARC, RARC and CAGC Rule - Update from CAQH CORE

MLN Matters Number: MM11709
Related CR Release Date: May 22, 2020
Related CR Transmittal Number: R10150CP
Related Change Request (CR) Number: 11709
Effective Date: October 1, 2020
Implementation Date: October 5, 2020

This article informs you of updates that the MACs and Shared System Maintainers (SSMs) will make to systems based on the Committee on Operating Rules for Information Exchange (CORE) 360 Uniform use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC), and Claim Adjustment Group Code (CAGC) rule publications. These system updates are based on the CORE Code Combination List to be published on or about June 1, 2020. Make sure that your billing staffs are aware of these updates.

The Department of Health and Human Services (DHHS) adopted the Phase III Council for Affordable Quality Healthcare (CAQH) CORE, Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Operating Rule Set that was implemented on January 1, 2014, under the Affordable Care Act of 2010.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)11709.


            Last Updated Fri, 29 May 2020 16:41:05 +0000