New CMS Remittance Advice Codes for PQRS Claims-Based Reporting: 3 Things to Know

Beginning July 1, Physician Quality Reporting System-eligible providers who participate in claims-based reporting must use the updated Remittance Advice Remark Codes, according to the Center for Medicare and Medicaid Services.

Here are three things to know about the new RARCs codes for PQRS claims-based reporting.

•    N620 code. Eligible providers who bill on a $0 Quality-Data Code line item will receive this code, which replaces the N365 code. This code indicates the PQRS codes were received by the CMS National Claims History database.
•    CO 246 N572 code. Eligible providers who bill on a $0.01 QDC line item will receive this code. This code indicates, with either group code CO or PR, that procedure is not payable unless non-payable reporting codes and correct modifiers are submitted.
•    On July 1, as the new codes take effect, the old codes will be deactivated.

CMS released a new FAQ to provide more information on the new codes.

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