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CMS Pub. 100-04, ch. 1, § 10.1.9.5

An A/B MAC (B) or DME MAC Receives a Claim for a

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

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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