Changes described in the ALERT dated November 5, 2021, regarding the replacement of Claim Adjustment Reason Code (CARC) Code 45 with CARC Code (96) will not be implemented. Gainwell verified CARC Code 45 still conforms to the Payment & Remittance Uniform Use of CARCs and RARCs (835) Rule. As a result, Alabama Medicaid will continue using CARC Code 45 to indicate pricing adjustments to payments due to fee schedules/allowed amounts.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.