The remark codes are to transmit information that could not be communicated wholly in 
the Adjustment Reason codes.  They are to be used when the situation described by the 
text associated with the code exists.  If none of the conditions described in the 
Remark code list exist, you do not have to issue any remarks.  If the Remark text adds 
nothing to what the Adjustment Reason already said, it need not be sent.

For Example, you would send a M81 code to communicate the sentence "We do not pay for 
this as the patient has no legal obligation to pay for this.".  The Reason code could 
something such as 96 - "Non-covered Charge(s)".   Together they make up the reason 
that nothing was paid, with the Remark code supplying detail for the Reason code.

Douglas M. Webb
Computer System Engineer
Little Company of Mary Hospital & Health Care Centers
[EMAIL PROTECTED]

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----- Original Message ----- 
From: "Fleming, Cindy R" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Cc: <[EMAIL PROTECTED]>
Sent: Monday, September 23, 2002 01:34 PM
Subject: RE: 835 codes


> Jan,
> Thank you for responding.  Could you please clarify for me the 'situations'
> where the remark codes are required?
> 
> Thanks,
> Cindy
> 
>  -----Original Message-----
> From: Jan Root [mailto:[EMAIL PROTECTED]] 
> Sent: Monday, September 23, 2002 10:39 AM
> To: [EMAIL PROTECTED]
> Subject: Re: 835 codes
> 
> Actually both are situational.  The CAS segments are both situational (use
> them
> when you made an adjustment).  The Remarks segments/elements (in the MIA,
> MOA,
> etc) are also situational.  I think payers are required be able to send
> information to explain adjustments.  The business goal is to reduce provider
> phone calls about payments!
> 
> Jan Root
> UHIN Standards Managers
> 
> [EMAIL PROTECTED] wrote:
> 
> > According to the Implementation Guide, the Adjustment Reason Code is
> > required and the Remark Code is optional. Let me know if anyone has other
> > information.
> >
> > > -----Original Message-----
> > > From: Fleming, Cindy R [SMTP:[EMAIL PROTECTED]]
> > > Sent: Friday, September 20, 2002 4:55 PM
> > > To:   '[EMAIL PROTECTED]'
> > > Subject:      835 codes
> > >
> > > The 835 transactions contains both a claims adjustment reason code and a
> > > remittiance remark code.  Are we required to provide both?
> > >
> > >
> > > Thanks for any information you may be able to share.
> > > Cindy Fleming
> > >
> > >
> > >
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