US · guidance
CMS Pub. 100-04, ch. 16, § 50.2.1
Assignment Required
Carriers must:
• Pay for clinical laboratory services provided in the physician’s office only on an
assignment basis.
• Treat as assigned any claims for clinical laboratory services provided in the
physician’s office even if the claimant submits the claim on a non-assigned basis
or if the assignment option is not designated.
• Deny claims where it is apparent from the claims form or from other evidence that
the beneficiary or provider refuses to assign.
The contractor shall use the following remittance advice message 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 or PR
CARC: 111
RARC: N/A
MSN: 16.41 OR 16.6
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
c5ba5020ba6266edd98b6b72833977bfb4ff26e9ccd4a218ef70ca2b8d483a93
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