US · guidance
CMS Pub. 100-04, ch. 14, § 60.1
Applicable Messages for NTIOLs
Contractors shall return as unprocessable any claims for NTIOLs containing Q1003 alone
or with a code other than one of the procedure codes listed in 40.3.
The contractor shall use the following remittance advice messages and associated codes
when returning claims under this policy. This CARC/RARC combination is compliant
with CAQH CORE Business Scenario Three.
Group Code: CO
CARC: 16
RARC: M67
MSN: N/A
Contractors shall deny payment for Q1003 if services are furnished in a facility other than
a Medicare-approved ASC.
The contractor shall use the following remittance advice messages and associated codes
when denying claims under this policy. This CARC/RARC combination is compliant
with CAQH CORE Business Scenario Three.
Group Code: CO
CARC: 58
RARC: N/A
MSN: 16.2
Contractors shall deny payment for Q1003 if billed by an entity other than a Medicare-approved ASC.
The contractor shall use the following remittance advice messages and associated codes
when denying claims under this policy. This CARC/RARC combination is compliant
with CAQH CORE Business Scenario Three.
Group Code: CO
CARC: 170
RARC: N/A
MSN: 33.1
Contractors shall deny payment for Q1003 if submitted for payment past the discontinued
date (after the 5-year period, or after February 26, 2011).
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: 27
RARC: N/A
MSN: 21.11
A/B MACs (B) shall deny payment for Q1003 if services are furnished in a facility other
than a Medicare-approved ASC.
The contractor shall use the following remittance advice messages and associated codes
when denying claims under this policy. This CARC/RARC combination is compliant
with CAQH CORE Business Scenario Three.
Group Code: CO
CARC: 58
RARC: N/A
MSN: 16.2
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
8880ddb4c4ccd7d73efc19a60d9d36fdec0ceb7a7e660b52e1f1a7256e5ee615
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