Claim Adjustment Reason Codes (CARCs), Remittance Advice Remark

20.2.2 - Claim Adjustment Reason Codes (CARCs), Remittance Advice Remark Codes (RARCs), Group Codes, and Medicare Summary Notice (MSN) Messages (Rev. 3844, Issued: 08-18-17, Effective: 01-01-18, Implementation: 01-02-18) When denying claim lines for HCPCS code 77063 that are not submitted with the diagnosis code V76.11 or V76.12, the contractor shall use the following remittance advice messages and associated codes when rejecting/denying claims under this policy. This CARC/RARC combination is compliant with CAQH CORE Business Scenario Three. CARC: 167 RARC: N386 MSN: 14.9 Group Code PR (Patient Responsibility) assigning financial responsibility to the beneficiary (if a claim is received with a GA modifier indicating a signed ABN is on file). Group Code CO (Contractual Obligation) assigning financial liability to the provider (if a claim is received with a GZ modifier indicating no signed ABN is on file). When denying claim lines for HCPCS code G0279 that are not submitted with HCPCS 77066 or 77065