What is the difference between the reason and remark codes that are used in remittance advice transactions?
Reason codes explain the basis for a denial, reduction or increase in payment for a service. Only reason codes may be reported in the claim adjustment segments of remittance advice transactions. Remark codes are reported in an MIA or MOA segment at the claim level, or in an LQ segment at the line level of an 835 remittance advice. Remark codes are usually used in conjunction with reason codes to explain appeal rights and to augment information expressed by a reason code. Remark codes cannot be used in and of themselves to deny or otherwise adjust a claim or service in a remittance notice.
