US · guidance
CMS Pub. 100-04, ch. 1, § 10.1.9.5
An A/B MAC (B) or DME MAC Receives a Claim for a
UMWA Beneficiary
(Rev. 3510, Issued: 04-29-16, Effective: 10-01-16, Implementation; 10-03-16)
When a local contractor (Part B MAC or carrier/DME MAC) receives a Form CMS-1500
or electronic claim that is identified as a UMWA claim for Medicare payment that should
be processed by the UMWA, 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: N127
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
156444aa941664d04b6bdb5ad16bb732d75d61436e11472fbf4a44919017d9fd
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