EDI Solutions

October 2024 EDI Front End Quarterly Release

Please be advised that while the Centers for Medicare & Medicaid Services mandated release for October 2024 will be installed the weekend of 10/6/2024, the code set updates included with this release will not be effective in the EDI Front-End processing system until Wednesday, 10/9/2024. EDI claims sent prior to 10/9/2024 that include any of the new or updated codes will reject in the EDI front-end.

Title & Description Purpose Trading Partner Impact
CR13633

SUBJECT: RARC, CARC , MREP and PC Print Update
This CR instructs the contractors and SSMs to update systems based on the CORE 360 Uniform Use of CARC and RARC Rule publication. These system updates are based on the CORE Code Combination List to be published on or about 7/1/2024. The codes and associated messages are updated in the updated versions of MREP codes.ini and PC Print code set update. Trading Partners should review the MedLearn Matters  article for this CR so that they are aware of the modifications that have been made to MREP and PC Print software to reflect the 7/1/2024 CARC and RARC changes. There is a new MREP Codes.ini file, which will be available for download from the CMS website.

There is a new PC Print code set update (October 2024), which may be downloaded from our website under Resources > EDI Solutions > EDI Software: PC Print > Download PC Print
CR13636

SUBJECT: Implement Operating Rules - Phase III ERA EFT: CORE 360 Uniform Use of CARC and RARC Rule - Update from CAQH CORE  6/1/2024

 
This CR instructs the contractors and Shared System Maintainers (SSMs) to update systems based on the CORE 360 Uniform Use of CARC and RARC Rule publication. These system updates are based on the CORE Code Combination List to be published on or about 6/1/2024. The codes and associated messages are updated in the updated versions of MREP codes.ini and PC Print code set update.

Trading Partners should review the MedLearn Matters  article for this CR  so they are aware of the Business Scenario combinations and RARC/CARC updates to the PC PRINT and MREP software.

There is a new MREP Codes.ini file, which will be available for download from the CMS website.

There is a new version of PC Print code set update (October 2024), which may be downloaded from our website under Resources > EDI Solutions > EDI Software: PC Print > Download PC Print


Posted 9/9/2024

Helpful Resources

EDI Front End Rejection Code Lookup Tool
Reset My EDI Password

Contact the EDI Help Desk

877-273-4334

Available by phone or email Monday–Friday*
8:00 a.m.–5:00 p.m. ET
8:00 a.m.–4:00 p.m. CT

* Closed for training on the 2nd and 4th Friday of the month.
12:00 p.m.–4:00 p.m. ET
11:00 a.m.–3:00 p.m. CT

Form(s) you'll need:

EDI Email Inquiry Form

Helpful Resources

EDI Front End Rejection Code Lookup Tool
Reset My EDI Password

Contact the EDI Help Desk

888-379-9132

Available by phone or email Monday–Friday*
8:00 a.m.–5:00 p.m. ET
8:00 a.m.–4:00 p.m. CT

* Closed for training on the 2nd and 4th Friday of the month.
12:00 p.m.–4:00 p.m. ET
11:00 a.m.–3:00 p.m. CT

Form(s) you'll need:

EDI Email Inquiry Form