Benefit maximum for this time period or occurrence has been reached.
Group code
CO, PI or PR
Category
Benefit Maximum/Limitation
Risk level
High
Appealable
Rarely
Common RARC pairings
RARCs (Remittance Advice Remark Codes) provide the specific reason detail alongside CARC 119 on the 835 electronic remittance. These are the RARCs seen most often with this CARC.
| RARC | Meaning |
|---|---|
| M7 | No rental payments after the item is purchased, returned or after the total of issued rental payments equals the purchase price. |
| M80 | Not covered when performed during the same session/date as a previously processed service for the patient. |
| M83 | Service is not covered unless the patient is classified as at high risk. |
| M86 | Service denied because payment already made for same/similar procedure within set time frame. |
| M89 | Not covered more than once under age 40. |
| M90 | Not covered more than once in a 12 month period. |
| M139 | Denied services exceed the coverage limit for the demonstration. |
| N45 | Payment based on authorized amount. |
See the full resolution workflow for CARC 119
Members of the EDI-Code Intelligence Lab get the step-by-step rework path, appeal language, root-cause drivers, and prevention checklist for every CARC and RARC pairing, plus payer-specific quirks.
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