MedicaidAdministrativeMedium impact
2024.13 - Provider Bulletin Claim Adjustment Reason Codes Changes on the X12 835 Health Care Claim Payment - Advice PDF
Connecticut Medicaid (HUSKY Health)·CT·Reimbursement
Effective date
May 1, 2024
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid is updating Claim Adjustment Reason Codes (CARCs) and Claim Adjustment Group Codes (CAGCs) on X12 835 remittance advices effective May 1, 2024. Nine specific EOB codes related to Medicare crossover claims will change from CAGC CO/CARC 22 to CAGC OA/CARC 23 to better distinguish Medicare crossover adjustments from Medicaid primary claim adjustments.
Action Required
By May 1, 2024: Billing team must update EHR software to capture new CARC/CAGC combinations (CAGC OA and CARC 23) for Medicare crossover claims. Contact trading partners or clearinghouses to inform them of the X12 835 updates. Review the updated Medical Assistance Program EOB Crosswalk at www.ctdssmap.com weekly for ongoing changes.