|No current requests. This list has been stable since the last update. It will not be updated until there are new requests.|
Industry Specific Remark Codes
These codes convey information about remittance processing or further explain an adjustment already described by a Claim Adjustment Reason Code (CARC) from ECL 139.
The list below shows the status of change requests which are in process.
Each request will be in one of the following statuses:
The request has been submitted but is not yet under review.
Staff has looked at the request to ensure it's a legitimate request (not spam), that it is assigned to the correct CMG, and that all required information is present.
- In Process
The CMG has initiated their decision process.
- On Hold
The CMG has initiated their decision process but cannot complete it at this time.
- CMG Approved
The CMG has considered and approved the request, this does not mean it was approved exactly as submitted, it means maintenance related to the request was approved. Requests in this status will be applied to the next version.
- CMG Disapproved
The CMG has considered and disapproved the request, no maintenance action will occur. Requests in this status are complete/final.
The injured employee or other party has not signed the required attestation document therefore Florida Statute 440.105(7) requires that benefits and payments be suspended until such signature is obtained.
Coverage based on a property and casualty Excess Insurance policy which is governed by state statute or regulation.
Reimbursement based on the treating hospital's designation as a lien hospital with billing precedence.
Reimbursement based on state-specific Workers' Compensation requirements for timely submission of bills for services rendered.
Reimbursement based on a state-specific Workers' Compensation limitation that the procedure code be billed only once, regardless of the number of limbs tested.
The provider's preliminary notice of injury and treatment was not furnished by the close of the third business day following the first treatment in accordance with Florida Statute Section 440.13(4)(a), therefore this claim is not considered valid.