Remark Codes (RARC)

A CARC (Claim Adjustment Reason Code) says why a payer adjusted a claim line; a RARC (Remittance Advice Remark Code) ad…

Remittance Advice Remark Codes (RARCs) are the supplemental messages on an ERA that explain an adjustment in detail or …

RARC M15 means the payer bundled services you billed separately because it considers them components of one procedure, …

RARC M16 is an Alert code: "Please see our web site, mailings, or bulletins for more details concerning this policy/pro…

RARC M25 means the payer reviewed the claim and decided the information furnished does not substantiate the need for th…

RARC M27 means the patient has been relieved of liability under the limitation of liability provision: the service was …

RARC M51 means the claim carried a missing, incomplete, or invalid procedure code — most often a CPT/HCPCS code that wa…

RARC M76 means the claim has a missing, incomplete, or invalid diagnosis or condition — a truncated ICD-10 code, a head…

RARC M77 means the place of service on the claim is missing, incomplete, invalid, or inappropriate for the procedure bi…

RARC M79 means the charge amount on the claim line is missing, incomplete, or invalid — a $0.00 or blank charge, a nega…

RARC M80 means the service is not covered because it was performed during the same session or date as a service the pay…

RARC M86 means the service was denied because payment was already made for the same or a similar procedure within a set…

RARC M97 means the service is not paid to the practitioner when provided in this place of service because payment is in…

RARC M117 means the claim is not covered unless submitted electronically. Medicare requires electronic submission under…

RARC M119 means the National Drug Code (NDC) on the claim is missing, incomplete, invalid, deactivated, or withdrawn — …

RARC M123 means the drug's name, strength, or dosage is missing, incomplete, or invalid on the claim — the payer cannot…

RARC M127 means the payer needs the patient medical record for this service and did not receive it — the claim hit a do…

RARC MA01 is an informational alert notifying you of appeal rights: if you disagree with the determination, you may app…

RARC MA04 means a secondary claim cannot be considered because the identity of, or payment information from, the primar…

RARC MA15 is an Alert code: your claim has been separated to expedite handling, and you will receive a separate notice …

RARC MA18 is an alert telling you the claim was automatically forwarded (crossed over) to the patient's supplemental in…

RARC MA27 means the entitlement number or name shown on the claim is missing, incomplete, or invalid — on Medicare clai…

RARC MA63 means the principal diagnosis on the claim is missing, incomplete, or invalid — the first-listed diagnosis fa…

RARC MA66 means the principal procedure code is missing, incomplete, or invalid — chiefly an institutional-claim proble…

RARC MA83 means the claim did not indicate whether the billed payer is primary or secondary — a Medicare Secondary Paye…

RARC MA130 means the claim contains incomplete or invalid information and is unprocessable: no appeal rights attach, an…

RARC N4 means the prior insurance carrier's explanation of benefits (EOB) is missing, incomplete, or invalid, so the se…

RARC N19 means the procedure code is incidental to the primary procedure — the payer considers it a minor, integral par…

RARC N30 means the patient is ineligible for the service billed — the benefit does not apply to this member under the p…

RARC N56 means the procedure code billed is not correct or valid for the services rendered or for the date of service —…

RARC N58 means the patient liability amount is missing, incomplete, or invalid on the claim — on a secondary/COB claim,…

RARC N95 means this provider type or specialty is not permitted to bill the service — the payer restricts the code to o…

RARC N115 means the payment decision was based on a Local Coverage Determination (LCD) — a Medicare contractor policy d…

RARC N130 tells you to consult the plan benefit documents or guidelines for restrictions that applied to this service —…

RARC N180 means the item or service does not meet the criteria for the category under which it was billed — the code yo…

RARC N265 means the ordering provider's primary identifier — the NPI of the provider who ordered the service — is missi…

RARC N286 means the referring provider's primary identifier — the NPI of the provider who referred the patient — is mis…

RARC N290 means the rendering provider's primary identifier — the individual NPI of the clinician who performed the ser…

RARC N291 means the rendering provider's secondary identifier — usually the taxonomy code or a payer-assigned number — …

RARC N357 means the required time frame between this service and a related service, procedure, or supply has not been m…

RARC N425 means the service is statutorily excluded — by law it is not a covered benefit under the program, most often …

RARC N479 means the explanation of benefits needed for coordination of benefits or Medicare Secondary Payer processing …

RARC N522 means the claim is a duplicate of one already processed, or to be processed, as a crossover claim — the prima…

RARC N598 means the payer's records show another health care policy is primary, so it is refusing responsibility as sec…

RARC N706 means "Missing documentation" — the payer processed your claim but cannot pay it as submitted because a requi…