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  • Core 360 Uniform use of CARC, RARC, and CAGC
  • Post author
    Lacy Gaskins

Core 360 Uniform use of CARC, RARC, and CAGC

The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) comply with a CORE operating rule set implemented January 1, 2014 as part of the Patient Protection and Affordable Care Act. Contractors including Shared System Maintainers (SSM) are instructed to update systems in accordance with CORE 360 Uniform use rules which change the handling of CARC, RARC and CAGC codes.

Full Transmittal: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2018Downloads/R4054CP.pdf

Subject: Implement Operating Rules –Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule - Update from Council for Affordable Quality Healthcare (CAQH) CORE

Number: 4054

Title: 10566

Release Date: May 18, 2018

Effective Date: October 1, 2018

Implementation Date: October 1, 2018

Special Notes: NA

  • Post author
    Lacy Gaskins

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