November 5, 2021

State of Alabama
Press Release: Medicaid

Coming Soon: Upcoming Changes to CARC Code 45

PDF Version


TO: All Providers

 

RE: Coming Soon: Upcoming Changes to CARC Code 45

 

 

Effective December 28, 2021, the Alabama Medicaid Agency will replace Claim Adjustment Reason Code (CARC) 45 with a new code to ensure compliance with the Committee on Operating Rules for Information Exchange (CAQH CORE) combinations reported on the X12 835 Electronic Remittance Advice (RA). The new CARC is as follows:


• CARC (96) - (Non-covered charge(s)) with an appropriate Recipient Advice Remark Code (RARC) for the situation.


UPDATE: These changes are currently available in our test environment for Provider and Vendor testing. Testing should be completed by December 24, 2021. The updated reporting will be implemented for claims appearing on the January 7, 2022 checkwrite going forward.


Providers with questions concerning the upcoming change can submit them via the following email address: interChange_testing@DXC.com.



The Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes descriptors, and other data are copyright © 2021 American Medical Association and © 2021 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.

 








  • For more information, visit http://medicaid.alabama.gov
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