Remittance Advice Codes

40.8 - Remittance Advice Codes (Rev. 3329, Issued: 08-14-15, Effective: 01-01-12, Implementation: 09-14-15) If high risk factors are not present, and the screening Pap smear and/or screening pelvic examination is being denied because the procedure/examination is performed more frequently than allowed, use existing ASC X12 835: • Claim adjustment reason code 119 - “Benefit maximum for this time period has been reached” at the line level, and • Remark code M83 - “Service is not covered unless the patient is classified as at high risk” at the line item level.