The Centers for Medicare & Medicaid Services (CMS) request that in a Coordination of Benefits Agreement (COBA) claims crossover process, Part B Medicare Administrative Contractors (MACs) use a valid and non-alert Remittance Advice Remark Code (RARC) in Coordination of Benefits (COB) fields, to ensure that 837 COB claims will have a proper CARC/RARC combination. Further, CMS request that a Part A system modifies outbound 837 COB and 835 ERA processes to make use of the RARC, and report informational alert RARCs in a 2320 MIA or MOA segment. To eliminate duplication of hospital day counts on outbound 837 institutional inpatient COB claims, a Part A system edit should prevent providers from entering certain hospital day counts.
Subject: Modifications to the National Coordination of Benefits Agreement (COBA) Crossover Process
Title: Change Request 9681
Release Date: Jan. 6, 2017
Effective Date: April 1, 2017
Implementation Date: April 3, 2017
Special Notes: Transmittal 1733, dated October 27, 2016, is being rescinded and replaced by Transmittal 1770, dated, January 6, 2017, to modify the example Types of Bills (TOBs) listing included in the last paragraph of the Policy section and in requirement 9681.3 to remove TOB 82x. All other information remains the same.