US · guidance
CMS Pub. 100-04, ch. 18, § 40.8
Remittance Advice Codes
If high risk factors are not present, and the screening Pap smear and/or screening pelvic
examination is being denied because the procedure/examination is performed more frequently than
allowed, use existing ASC X12 835:
• Claim adjustment reason code 119 - “Benefit maximum for this time period has been
reached” at the line level, and
• Remark code M83 - “Service is not covered unless the patient is classified as at high risk”
at the line item level.
History
(Rev. 3329, Issued: 08-14-15, Effective: 01-01-12, Implementation: 09-14-15)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
849b36cc067d3bd0712c4a08fa35f1313a5bcf3cdf4a8a2ae578cdbc1669965d
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