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US · guidance

CMS Pub. 100-04, ch. 17, § 80.2.3

MSN Denial /Claim Adjustment and Remark Messages for Anti-Emetic

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

Drugs

(Rev. 3721, Issued: 02-24-17, Effective: 05-25-17, Implementation: 05-25-17)

If the claim for an anti-emetic drug is denied because FDA did not approve it, 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: 114

RARC: N/A

MSN: 6.2

If the claim for an anti-emetic drug is denied because the drug is not being used as part of an anticancer

chemotherapeutic regimen, 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: 96

RARC: M100

MSN: 6.4

History

(Rev. 3721, Issued: 02-24-17, Effective: 05-25-17, Implementation: 05-25-17)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
b2c53638d9e6ecd25ec23752f4bff12300fe1bca65d16ed7a300ab75590f6b0e
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