Payment is denied when performed/billed by this type of provider. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Group code
CO, PI or PR
Category
Credentialing/Enrollment
Risk level
High
Appealable
Review Required
Common RARC pairings
RARCs (Remittance Advice Remark Codes) provide the specific reason detail alongside CARC 170 on the 835 electronic remittance. These are the RARCs seen most often with this CARC.
| RARC | Meaning |
|---|---|
| M114 | This service was processed in accordance with rules and guidelines under the DMEPOS Competitive Bidding Program or a Demonstration Project. For more information regarding these projects, contact your local contractor. |
| M143 | The provider must update license information with the payer. |
| N90 | Covered only when performed by the attending physician. |
| N95 | This provider type/provider specialty may not bill this service. |
| N348 | You chose that this service/supply/drug would be rendered/supplied and billed by a different practitioner/supplier. |
| N665 | Services by an unlicensed provider are not reimbursable. |
| N732 | Services performed at an unlicensed facility are not reimbursable. |
| N912 | Our records indicate that this beneficiary did not elect hospice. |
See the full resolution workflow for CARC 170
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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