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.

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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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