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Codes

Carrier Codes

Carrier codes—National Electronic Insurance Clearinghouse (NEIC) codes that identify insurance carriers—are necessary to complete claims that involve Third Party Liability. Therefore, we’re making the Carrier Codes available below.

When you submit a 270 Eligibility Request transaction, the system sends you a 271 Eligibility Response. If we have Third Party Liability information on file for the client, that information (including the carrier code) is listed on the response.

The Carrier Codes Report is a cross-reference of carrier codes to insurance company names, in alphabetical order by company name. This report is generated quarterly by the Arkansas Medicaid Management Information System. If the carrier you’re looking for is not listed in the Carrier Codes Report, use the default code XXX (which means unknown carrier code) to bill the TPL amount paid or submit a TPL denial date.

NOTE: Alpha characters in carrier codes must be uppercase.

DocumentFile NameFile SizeLast Update
Carrier Codes Reportcarriers.pdf423k7/6/24
Third-Party Liability Unit Contact InformationDMSTPL.doc31k8/22/14

Code Conversion Notices Archive

View the notice archive file.

Long Term Care Codes

Updated 1/28/19
If you are billing for Long Term Care services, you need the following codes, which are used only for Long Term Care.

Type of Bill
(First and Second Digits)
Description
21Skilled Nursing Facility (SNF) Inpatient
22Skilled Nursing Facility (SNF) Inpatient, Part B
23Skilled Nursing Facility (SNF) Outpatient
65Intermediate Care Facility (ICF) Intermediate Care-I
66Intermediate Care Facility (ICF) Intermediate Care-II
81Special Facility Non-Hospital / Hospice
82Special Facility Hospital / Hospice
Type of Bill
(3rd Digit)
Description
1Admit Through Discharge Claim
2Interim – First Claim
3Interim – Continuing Claims
4Interim – Last Claim
8Void/Cancel of a Prior Claim
Patient StatusDescription
01Discharged to Home or Self Care
02Discharged/Transferred to Another Short-Term General Hospital
03Discharged/Transferred to SNF
04Discharged/Transferred to an Intermediate Care Facility (ICF)
05Discharged/Transferred to Another Type of Institution
06Discharged/Transferred to Home Under Care of Organized
Home Health Service Organization
07Left Against Medical Advice
20Expired
30Still Patient
Homestyle Revenue CodeDescription
184LOA HOME – Home Style Facility
186LOA Hospital 85% or Greater Occupancy – Home Style Facility
187LOA Hospital Less than 85% Occupancy – Home Style Facility
188LOA No Pay – Home Style Facility
199Home Style Facility All LOC
659Hospice Room and Board – Home Style Bed
Traditional Style
Revenue Code
Description
180LOA Hospital less than 85% occupancy – Traditional Style Bed or ICF/IID
183LOA – Home – Traditional Style Bed or ICF/IID
185LOA Hospital 85% or greater occupancy – Traditional Style Bed or ICF/IID
189LOA No Pay – Traditional Style Bed or ICF/IID
190Skilled Nursing – Traditional Style Bed
191Intermediate I – Traditional Style Bed
192Intermediate II – Traditional Style Bed
193Intermediate III – Traditional Style Bed
194ICF/IID
658Hospice Room and Board – Traditional Style Bed or ICF/IID

National Codes Crosswalk to Arkansas EOB Codes

DocumentFile NameFile SizeLast Update
National Codes Crosswalk to Arkansas EOB Codes
(This document also includes lists of claim status codes, adjustment reason codes, and remittance advice remark codes.)
eob.xls1.4 MB12/8/16

National Correct Coding Initiative (NCCI) Inpatient Only Procedure Codes and Information

Updated 4/13/22
The Patient Protection and Affordable Care Act ((H.R. 3590) Section 6507 (Mandatory State Use of National Correct Coding Initiative (NCCI)) requires State Medicaid programs to incorporate “NCCI methodologies” into their claims processing systems. The Centers for Medicare and Medicaid Services (CMS) originally developed the NCCI to promote national correct coding methodologies and to control improper coding leading to inappropriate payments in Medicare Part B claims. The purpose of the NCCI edits is to prevent improper payments when incorrect code combinations are reported. Arkansas Medicaid implemented NCCI methodologies for claims with dates of service on or after 4/1/11.

Official Notices Regarding NCCI Implementation

DateNumberSubject
1/1/15ON-004-14National Corrective Coding Initiative New Procedure-to-Procedure (PTP) – Associated Modifiers
10/1/11ON-007-11National Correct Coding Initiative
4/1/11ON-004-11National Correct Coding Initiative

Remittance Advice Messages Regarding NCCI Implementation

DateSubject
5/22/14-5/29/14NCCI Auditing of EPSDT/Sick Visit Rendered Same Date of Service
4/11/13-4/18/13National Correct Coding Initiative (NCCI) 2013 Quarterly Update
12/20/12-12/27/12National Correct Coding Initiative (NCCI) Methodologies

NCCI Inpatient Only Procedure Codes

Document NameFile SizeLast Update
2024 Q4 NCCI Inpatient Only Procedure Codes29k9/30/24
Archived NCCI Inpatient Only Procedure Codes
(Each tab is a previous quarter’s codes.)
224k9/30/24

Procedure Code Tables

View procedure code tables.

X12 Codes

X12, chartered by the American National Standards Institute, develops and maintains EDI standards  which drive business processes globally.