General Question for the Week of November 28, 2016

General Compliance Question of the Week

Question:

What is the difference between the Medicare remark codes and the reason codes?

Answer:

Medicare Administrative Contractors (MACs) use two different sets of codes on the claim to communicate with the provider. Claim adjust¬ment reason codes (CARCs) provide financial information about claim decisions and inform the provider why adjustments were made on the claim or a line item. Remittance advice remark codes (RARCs) provide further explanation of an adjustment that the CARCs cannot explain.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.