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January 2022 EDI Front End Quarterly Release

Please be advised that while the Centers for Medicare & Medicaid Services mandated release for January 2022 will be installed the weekend of 1/2/2022, the code set updates included with this release will not be effective in the EDI Front-End processing system until Wednesday, 1/5/2022.  EDI claims sent prior to 1/5/2022 that include any of the new or updated codes will reject in the EDI front-end.

Title & Description Purpose Trading Partner Impact
CR12428 (CAQH CORE CR)

SUBJECT: Implement Operating Rules - Phase III ERA EFT: CORE 360 Uniform Use of CARC and RARC Rule - Update from CAQH CORE

MLN MattersĀ® Article MM12428
This CR instructs the contractors and Shared System Maintainers (SSMs) to update systems based on the CORE 360 Uniform Use of CARC and RARC Rule publication. These system updates are based on the CORE Code Combination List to be published on or about 11/1/2021. The codes and associated messages are updated in the updated versions of MREP codes.ini and PC Print code set update. Trading Partners should review the MLN MattersĀ® article for this CR so they are aware of the Business Scenario combinations and RARC/CARC updates to the PC PRINT and MREP software.

There is a new MREP Codes.ini file, which will be available for download from the CMS website.

There is a new code set update January 2022 for PC Print, which may be downloaded from our website under RESOURCES > EDI Solutions > EDI Software: PC Print > Download PC Print

Posted 12/6/2021