Tables: CAR Codes

CAR (Claim Adjustment Reason) Codes are used if your practice processes EDI Remittance or you want to send secondary or tertiary claims electronically, and manually post insurance payments. These are the ‘REMARK’ codes referenced on EOB’s to further explain adjudication notations. This table allows for creating a description visible on the transaction when automatically posted.  It also allows for ACTIONS to occur when the code is referenced on an EOB.  Creating an automatic adjustment transaction or changing the status of an item to REVIEW is available. Viewing the Remark codes on past EOB’s will give the practice an idea of the codes used for your transactions in your practice.

Use Find to locate commonly encountered CAR Codes and then open the CAR Code form to edit settings (if the Remark Code starts with CO, PR, or OA, only type the corresponding number.)

1. Short Description: If the official Description is wordy, enter a Short Description as you would like it to appear on the Ledger.
2. TX Code: Select the appropriate transaction code, if any. If a TX Code is selected, an automatic transaction is created. UCR is commonly linked with the CO-45 displayed in the picture shown above.
3. Set Review Status: Check box to change the status of items with this code to “X” for Review. Codes marked here will be reported in the Process Log after the Automatic Processing of EDI Remittance.
4. Create TX Note: Check this box to create a note on the transaction. The note is visible on the ledger and is recommended to further explain the reason for the remark code. The text displayed in the Short Description field is shown on the ledger.
5. Save.