Medicare Summary Notice (MSN) and Claim Adjustment Reason Codes (CARCs) for HIV Screening Tests (Rev. 2199, 07-06-10)

by  Jared Staheli
July 6th, 2015

a. When denying claims for HIV screening submitted without ICD-9 diagnosis codes V73.89, or V73.89 and V69.8, use the following messages:

MSN 16.10 - Medicare does not pay for this item or service.

“Medicare no paga por este articulo o servicio”

CARC 167- This (these) diagnosis(es) is (are) not covered.

Group Code CO (Contractual Obligation)

b. When denying claims for HIV screening, use the following denial messages:

MSN 15.22 – The information provided does not support the need for this many services or items in this period of time so Medicare will not pay for this item or service.

“La informacíón proporcionada no justifica la necesidad de esta cantidad de servicios o articulos en este periodo de tiempo por lo cual Medicare no pagará por este articulo o servicio.”

CARC 119 – Benefit maximum for this time period or occurrence has been reached.

Group Code CO (Contractual obligation).

References:

Medicare Summary Notice (MSN) and Claim Adjustment Reason Codes (CARCs) for HIV Screening Tests (Rev. 2199, 07-06-10). (2015, July 6). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/medicare-summary-notice-msn-and-claim-adjustment-reason-codes-carcs-for-hiv-screening-tests-rev-2199-07-06-10-27038.html

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