CAQH CORE: Updated Version Available: October 2013 CORE Code Combinations v3.0.3

Wednesday, October 2, 2013

Updated Version Available: October 2013 CORE Code Combinations v3.0.3

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Updated Version Available for Implementation:
October 2013 CORE Code Combinations v3.0.3

To: All HIPAA Covered Entities and Business Associates
  
From: The CAQH CORE Code Combinations Task Group Co-Chairs
  
The purpose of this communication is to announce that an updated version of theCORE-required Code Combinations for the CORE-defined Business Scenarios (CORE Code Combinations) is now available for use with CAQH CORE 360: Uniform Use of CARCs and RARCs Rule. CAQH CORE Rule 360 enables more uniform use of the Claim Adjustment Reason Codes (CARCs) and Remittance Advice Remark Codes (RARCs) by targeting a minimum set of common or problematic Business Scenarios along with a maximum specified set of code combinations for each of these Scenarios. The CORE Code Combinations must be updated to align with the current published CARC and RARC lists which are maintained by code committees and updated at least three times per year.
 
The CORE-required Code Combinations for the CORE-defined Business Scenarios v3.0.3 October 2013 is now available on the CAQH CORE website for use with CAQH CORE 360 Rule. The October 2013 CORE Code Combinationsincludes Compliance-based Adjustments to the CORE Code Combinationsapproved by the CAQH CORE Code Combinations Task Group based on the July 2013 published CARC and RARCs lists. A marked-up version of the October 2013 CORE Code Combinations showing Compliance-based Adjustments between v.3.0.2 and v.3.0.3 is available HERE and a table summarizing the adjustments is available HERE.

CAQH CORE 360 Rule is part of the ACA mandated CAQH CORE EFT & ERA Operating Rules which all HIPAA covered entities are required to implement byJanuary 1, 2014. The October 2013 CORE Code Combinations is the third of regular version updates to the CORE Code Combinations for use with CAQH CORE 360 Rule. By January 2014, entities should have an established process and policy for implementing the regular updates to the CORE Code Combinations.  

For more information visit the Ongoing Maintenance of the CORE Code Combinations for CAQH CORE 360 Rule Webpage which is a "one stop shop" for all the necessary tools and information to comply with CAQH CORE 360 Rule and the ongoing maintenance process. The CAQH CORE Code Combinations Task Group is in the final steps of preparation for the first Market-based Review of theCORE Code Combinations. CORE Participants are encouraged to get involved with the Task Group.

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