Medicare Claims Processing Manual (Pub. 100-04), Ch. 10 § 20.2.4
Only Notice of Admission (NOA) Received and Services Fall
20.2.4 - Only Notice of Admission (NOA) Received and Services Fall
Within Admission Period
(Rev. 10758; Issued: 05-11-21; Effective: 01-01-22; Implementation: 08-11-21)
If only an NOA has been received and the incoming claim with services subject to
consolidated billing contains dates of service within the HH admission period, CWF
returns an alert to the Medicare contractor to notify them that the claim may be subject to
consolidated billing. The Medicare contractor processes the claim to payment, but passes
on the alert to the provider on the remittance advice at the line level.
The contractor shall use the following remittance advice messages and associated codes
when making payment under this policy. The CARC below is not included in the CAQH
CORE Business Scenarios.
Group Code: CO
CARC: N/A
RARC: N88
MSN: N/A
This indicates to providers that the services may be denied and claim payment may be
recouped if later editing or another post-payment recovery process identifies the claim as
subject to consolidated billing.