Disposition Code 53 (Record in CMS Alpha Match)

20.3.3.4 - Disposition Code 53 (Record in CMS Alpha Match) (Rev. 4047, Issued: 05-11- 18, Effective: 08-13-18, Implementation: 08-13-18) • If CMS sends a claim to alpha search, it must send a disposition code 53 to the Host. The Host puts a code 53 on its TNIF file. • The Satellite receives code 53 and Trailer 08 with a 5052 error code on the next recycle of the claim. • The Satellite must recycle the claim 15 working days after receiving this code. • If an AAR response is not received after the receipt of the third code 53 for the same claim, the Satellite must deny the claim using the following messages: MSN message 5.1: "Our records show that you do not have Medicare entitlement under the number shown on this notice. If you do not agree, please contact your local Social Security office." Group Code CO, Claim Adjustment Reason Code (CARC) 16 (Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. Do not use this code for claims attachment(s)/other documentation. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present), and Remittance Advice Remark Code (RARC) N382 - Missing/incomplete/invalid patient identifier.