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CMS Pub. 100-04, ch. 1, § 10.1.9.2

An A/B MAC (B) Receives a Claim for Services that are in a

activein force · 2026-08-25 – presentas-observed

DME MAC’s Payment Jurisdiction

(Rev. 3510, Issued: 04-29-16, Effective: 10-01-16, Implementation; 10-03-16)

When a local contractor (Part B MAC or carrier) receives a CMS-1500 or electronic

claim for Medicare payment for items/services that are in a DME MAC’s payment

jurisdiction, the claim shall be returned as unprocessable.

The contractor shall use the following remittance advice messages and associated codes

when rejecting/denying claims under this policy. This CARC/RARC combination is

compliant with CAQH CORE Business Scenario Three.

Group Code: CO

CARC: 109

RARC: N104

MSN: N/A

History

(Rev. 3510, Issued: 04-29-16, Effective: 10-01-16, Implementation; 10-03-16)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
4be40ec2f07fc9ca83514628df4c5fb8c278e1b5cd7bc7ca0900f5e75bb11dc6
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