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MedicaidAdministrativeMedium impact

Reason Codes on Denial of Claims

Missouri Medicaid (MO HealthNet)·MO·Provider Notice
Effective date
Feb 10, 2014
We identified it
Jun 20, 2026
Days to comply

Summary

MO HealthNet has provided access to standardized healthcare code lists including Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC) through Washington Publishing Company's website. These codes help explain claim adjustments and denials for better understanding of payment processing.

Action Required

Action needed
Immediately: Billing team should bookmark and utilize the WPC healthcare code lists accessible through MO HealthNet Provider Participation page under 'HIPPA Related Code Lists'. Use these standardized codes to better understand claim adjustments, denials, and remittance advice explanations when processing MO HealthNet claims.