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The WEDI/X12 835 CARC/Group Code Matrix Survey Results

October 18, 2006
This report offers the analysis of a small ad hoc workgroup focused on the question of which Group Code (contractual adjustment, patient responsibility, etc.) should be used with each of the Claims Adjustment Reason Codes in the 835 Remittance Advice transaction. Organizers had hoped for a quick consensus, but instead uncovered a variety of interpretations. Participants suggested a greater focus on the capability of proper 835 coding -- as established by consensus among payers and providers alike -- could enhance the adoption rate of this valuable transaction. The patterns found in the group's responses suggested a way forward.