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Last Modified: 10/14/2018 Location: FL, PR, USVI Business: Part B

Return unprocessable claim (RUC) reason code CO 181 FAQ

Q: We received a RUC for claim adjustment reason code (CARC) CO 181. What steps can we take to avoid this RUC code?
Procedure code was invalid on the date of service.
A: You received this RUC because the Current Procedural Terminology® (CPT®) or Healthcare Common Procedure Coding System (HCPCS) code billed was invalid or not active for Medicare on the date(s) of service (DOS) on the claim. Note that while a CPT® or HCPCS code may currently be valid, it may not be valid for the DOS on your claim.
CPT® codes are revised annually by the American Medical Association (AMA), with changes effective January 1. Make sure that you are using a valid CPT® book for the DOS on your claim.
HCPCS codes are updated quarterly (beginning in January) by The Centers for Medicare & Medicaid Services (CMS). Review quarterly updates at CMS Healthcare Common Procedure Coding System (HCPCS) Quarterly update website external link.
Verify the procedure code you’re billing for is valid/active and payable by Medicare for the DOS on your claim via the Medicare physician fee schedule lookup.
Consider ABILITY | PC-ACE™ software, updated with the most current CPT® codes, to ensure claims are submitted with valid procedure codes. Click here for information on ABILITY | PC-ACE™ software, offered by First Coast.
Submit separate claims for services in different years of service. A procedure code may be valid one year and not valid the following year.
To avoid delay in payment, submit a corrected claim with a valid CPT® or HCPCS code. Claims returned as unprocessable cannot be appealed, as an initial determination was not made. For more information, click here.
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Source: First Coast Education Action Team
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.