Section title: Requests for Interpretation
RFI #
1106
5010 835-Reversal CARC usage
Description

Section 1.10.2.8 of the 5010 states:
"Reversing the original claim payment is accomplished with code 22, "reversal of previous payment", Send original Claim Adjustment group codes in CAS01; and appropriate adjustments. All original charge, payment, and adjustment amounts are negated."

What is the ruling for CARC values that may be deactivated at the time the reversal 835 is created and sent to the provider? Is it ok to report these deactivated CARC values on the reversal 835?

RFI Response

This issue is not addressed in the guide, but by the owning committee for the Claim Adjustment Reason Code list. See their definition and restrictions on usage of stop dated codes at: http://www.wpc-edi.com/content/view/702/397/

DOCUMENT ID
005010X221