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Thread: Medicare denial code

  1. #1

    Default Medicare denial code

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    Has anyone see the medicare denial code CO-223 and do you understand what it is trying to tell us?

  2. #2
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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

  3. #3
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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.

    Debra A. Mitchell, MSPH, CPC-H

  4. #4

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    lattona1--I know where to find the descripton but I do not understand this one.

  5. #5

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    mitchellde--99213

  6. #6
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    It is the 2% Medicare sequestration cut that went into effect April 1,2013

  7. #7
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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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