Date
Washington Publishing Company (WPC) provides Health Care Code Lists. The WPC web site can be accessed from the MO HealthNet Provider Participation page. Under Featured Links, found on the right side of the web page, choose HIPPA Related Code Lists.
On the WPC page you will find the following Health Care Code Lists:
- Claim Adjustment Reason Codes (CARC)
- Claim adjustment reason codes communicate an adjustment, meaning that they must communicate why a claim or service line was paid differently than it was billed. If there is no adjustment to a claim/line, then there is no adjustment reason code.
- Remittance Advice Remark Codes (RARC)
- Remittance Advice Remark Codes (RARCs) are used to provide additional explanation for an adjustment already described by a Claim Adjustment Reason Code (CARC) or to convey information about remittance processing.
- Claim Status Category Codes
- Claim Status Category codes indicate the general category of the status (accepted, rejected, additional information requested, etc.) which is then further detailed in the Claim Status Codes.
- Claim Status Codes
- Health Care Claim Status Codes convey the status of an entire claim or a specific service line.
- Health Care Service Type Codes
- Health Care Service Type Codes are used to identify the classification of service or benefits.
- Health Care Services Decision Reason Codes
- Health Care Services Decision Reason Codes are used to indicate the primary reason for the certification action code assigned as part of a health care services review.
- Provider Characteristics Codes
- This code list is for use with health care provider information for enrollment and credentialing transactions and their corresponding responses.
- Insurance Business Process Application Error Codes
- This code set is for use in reporting application errors for insurance business processes.