Updated CORE Code Combinations June 2015

Updated Version Available for Implementation: June 2015 CORE Code Combinations v3.2.0 -  Includes Adjustments for 2014 Market-Based Review and  the Latest Compliance-based Review To: All HIPAA Covered Entities and Business Associates  From: The CAQH CORE Code Combinations Task Group Co-Chairs An updated version of the CORE-required Code Combinations for the CORE-defined Business Scenarios (CORE Code Combinations) is now available for use with the CAQH CORE 360: Uniform Use of CARCs and RARCs Rule. The CAQH CORE 360 Rule 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 amaximum specified set of code combinations for each of these Scenarios. Per CAQH CORE policy, the CORE Code Combinations must be updated by Task Group approval to both: Align with the current published CARC and RARC lists which are maintained by code committees and updated at least three times per year. (Compliance-based reviews) Address an annual review. (Market-based reviews) The CORE-required Code Combinations for the CORE-defined Business Scenarios v3.2.0 June 2015 is now available on the CAQH CORE website for use with the CAQH CORE 360 Rule. The June 2015 CORE Code Combinationsincludes: Compliance-based Adjustments as a result of code list updates published on March 1st and April 15th Market-based Adjustments to the existing four CORE-defined Business Scenarios based upon the 2014 Market-based Review A marked-up version of the June 2015 CORE Code Combinations showing both Compliance-based and Market-based Adjustments between v.3.1.3 and v.3.2.0 is available HERE. The Change Log in the second tab of the CORE Code Combinations provides a list of all adjustments made to the CORE Code Combinations. For more information visit the Ongoing Maintenance of the CORE Code Combinations for CAQH CORE 360 Rule Webpage, a "one stop shop" for all the necessary tools and information to comply with the CAQH CORE 360 Rule and the ongoing maintenance process. This website page includes a summary of the updates and links to detailed updates. In July, the CAQH CORE Code Combinations Task Group will launch its next Compliance-based Review in order to review updates from the code list authors that are scheduled for publication in July 2015. During this review cycle, the Task Group will also complete its Market-based Review of the potential new CORE-defined Business Scenarios submitted via the Industry-wide CAQH CORE 2014 Market-based Adjustments Form. CAQH CORE Participants are encouraged to get involved with the Task Group. Please do not hesitate to contact core@caqh.org with any additional questions.