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Medicare

Marilyn Posted Sun 01st of February, 2015 19:46:56 PM

What does this Medicare "237 Legislated/Regulatory Penalty" mean?

SuperCoder Answered Mon 02nd of February, 2015 09:36:08 AM

Thank you for your question.

Providers who receive the 2012 eRx payment adjustment will see the
term “LE” on their Remittance Advice for all Medicare Part B services
rendered January 1–December 31, 2012.

The remittance advice will also contain the following Claim Adjustment Reason Code (CARC) and Remittance Advice Remark Code (RARC):

oCARC 237–Legislated/Regulatory Penalty. At least one Remark
Code must be provided (may be comprised of either the NCPDP
Reject Reason Code, or Remittance Advice Remark Code that is
not an ALERT).

http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/se1141.pdf

Marilyn Posted Mon 02nd of February, 2015 21:14:19 PM

So this has to with RX prescribing? This are clinical physchologists that does not prescribe.

SuperCoder Answered Mon 02nd of February, 2015 21:37:16 PM

Yes the remittance code is referring to eRX. This measure applies to eligible providers with prescribing privileges. There are exemptions that may apply for some providers. You should contact QualityNet in order to get additional assistance. QualityNet is available for providers to ask questions and discuss problems that they are having with reporting. See the attached link for QualityNet contact information.

http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/ERxIncentive/HelpDeskSupport.html

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