US · guidance
CMS Pub. 100-04, ch. 1, § 10.1.9.2
An A/B MAC (B) Receives a Claim for Services that are in a
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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