Section title: Requests for Interpretation
RFI #
2626
Informational RARCs vs Supplemental RARCs (835)
Description

In the case where there is no adjustment on the 835 Remit (that is, no CAS segment at the claim level or service line level / no CARCs), can "Informational" RARCs (Alerts) be used in the MIA, MOA and LQ segments? Also, can "Supplemental" RARCs be used in this situation, or ONLY Alerts?

Scenario

In the case where there is no adjustment on the 835 Remit (that is, no CAS segment at the claim level or service line level / no CARCs), can "Informational" RARCs (Alerts) be used in the MIA, MOA and LQ segments? Also, can "Supplemental" RARCs be used in this situation, or ONLY Alerts?

RFI Response

Remark codes can be used without any association to a specific CARC, at either the claim or service level (some of these remark codes begin with the word “ALERT”). Remark codes used without any association to a specific CARC are included in the claim level (2100 Loop) Inpatient Adjudication Information (MIA) or Outpatient Adjudication Information (MOA) or service level (2110 loop) Health Care Remark Codes (LQ) segments.

DOCUMENT ID
005010X221