Issue Corrected: Attn Section 21 and 29 Waiver Providers, CR 41382

May 2, 2014

Sections 21 and 29 waiver service claims with code T2021 are no longer denying in error.

Below, is the original message we sent on February 11, 2014, explaining the issue that has now been corrected:

Attn Section 21 and 29 Waiver Providers, CR 41382

An issue was identified where Section 21 and 29 waiver service claims with code T2021 were denied in error.

You will see the following Claims Adjustment Reason Code (CARC) and/or Remittance Advice Remark Code (RARC) on a future Remittance Advice, and corresponding edits can be viewed on the MyHealthPAS Portal:

  • CARC - 119 - Benefit maximum for this time period or occurrence has been reached.

  • RARC N640 - Exceeds number/frequency approved/allowed within time period.

  • Edit 271-benefit restriction group validation failed

  • Edit 206 benefit visit limit exceeded.

We will notify you when this issue is corrected. Affected claims will be reprocessed and no provider action is needed.