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Old 04-19-2013, 02:34 PM
mcrump mcrump is offline
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Default Medicare denial code

Has anyone see the medicare denial code CO-223 and do you understand what it is trying to tell us?
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Old 04-19-2013, 05:13 PM
latonna1 latonna1 is offline
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usually if you look at the bottom of the EOB or RA whatever. It gives the description of the codes. Hope that helps
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Old 04-19-2013, 05:31 PM
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223 Adjustment code for mandated federal, state or local law/regulation that is not already covered by another code and is mandated before a new code can be created.

I have no idea what this means, what codes were on this claim? what line Item was this attached to.
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Old 04-19-2013, 07:02 PM
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lattona1--I know where to find the descripton but I do not understand this one.
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Old 04-19-2013, 07:04 PM
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mitchellde--99213
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Old 04-19-2013, 08:05 PM
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It is the 2% Medicare sequestration cut that went into effect April 1,2013
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Old 04-22-2013, 10:14 AM
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Wink Sequestration Q&As, mentions the CARC 223

Here is a link I found regarding this topic.

Sequestration Q & A's

Question: How is the 2% payment reduction under sequestration identified on the electronic remittance advice (ERA) and the standard paper remittance (SPR)?

Answer: Claim adjustment reason code (CARC) 223 is used to report the sequestration reduction on the ERA and SPR.

Question: What is the verbiage for CARC 223?

Answer: "Adjustment code for mandated Federal, State or local law/regulation that is not already covered by another code and is mandated before a new code can be created."

Question: Will the 2% reduction be reported on the remittance advice in a separate field?

Answer: For institutional Part A claims, the adjustment is reported on the remittance advice at the claim level. For Part B physician/practitioner, supplier, and institutional provider outpatient claims, the adjustment is reported at the line level.

Link:
http://www.cgsmedicare.com/jc/pubs/n...cope21672.html
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