Learn More about the New Remittance Advice Codes for PQRS Claims-Based Reporting

Are you a PQRS eligible professional participating in claims-based reporting this year? Effective July 1, 2014, you will have to use the updated Remittance Advice Remark Codes (RARCs) for PQRS claims-based reporting that went into effect on April 1, 2014.

CMS has released a new FAQ with information about the updated codes.

What are the New Codes and What Do They Mean?

Eligible professionals who bill on a $0.00 Quality-Data Code (QDC) line item will receive the N620 code, which replaces the current N365 code. Also, eligible professionals who bill on a $0.01 QDC line item will receive the CO 246 N572 code.

• The new RARC code N620 will be your indication that the PQRS codes were received into the CMS National Claims History (NCH) database.
• The new RARC code N572with the Claim Adjustment Reason Code 246 (with Group Code CO or PR) indicates that the procedure is not payable unless non-payable reporting codes and appropriate modifiers are submitted.

Remember: The new codes will be effective on July 1, 2014. The old codes will be deactivated on the same date.

For More Information
If you require further information, please contact the QualityNet Help Desk at 1-866-288-8912 or via [email protected]. They are available from 7:00 a.m. to 7:00 p.m. CST Monday through Friday.

For more information on PQRS, please visit the PQRS webpage.