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US · guidance

CMS Pub. 100-04, ch. 13, § 140.2

Denial Messages for Noncovered Bone Mass Measurements

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

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

when rejecting/denying claims under the conditions described in 140.1. This

CARC/RARC combination is compliant with CAQH CORE Business Scenario Three.

Group Code: PR (if claim is received with a GA modifier) otherwise CO

CARC: 50

RARC: Alert M38 (if ABN was issued) or M27 (if ABN was not issued)

MSN: 16.10 and 36.1 (if ABN was issued) or 36.2 (if ABN was not issued)

NOTE: A/B MACs (A) are not to include MSN 16.10.

History

(Rev. 3650, Issued: 11-10-16, Effective: 02-10-17, Implementation: 02-10-17)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
05ca94b2147bed687b1ac249fb329e31dfa1add8cbb6868a31e26fd602a57966
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CMS Pub. 100-04, ch. 13, § 140.2 — Denial Messages fo… · binding.law