Coding to the Highest Level of Specificity - JF Part B
Code to Highest Level of Specificity
| CARC/RARC | Description |
|---|---|
| CO-16 | Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. |
| M81 | You are required to code to the highest level of specificity. |
Common Reasons for Message
- Truncated (invalid) Diagnosis Code
- Scanning Error (paper claim)
Next Step
- Verify diagnosis codes submitted are valid
- If there is a 5 digit code, do not use a 3 or 4 digit code
- For paper claims, if all diagnosis codes submitted are verified and are valid, contact Provider Contact Center (PCC) to ensure there were no errors in scanning claim
Claim Submission Tips
- To avoid scanning errors when submitting, be sure to follow CMS printing standards
Last Updated Dec 09 , 2023
