Payment is denied when performed/billed by this type of provider in this type of facility. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Group code
CO, PI or PR
Category
Provider/Facility Eligibility
Risk level
High
Appealable
Review Required
Common RARC pairings
RARCs (Remittance Advice Remark Codes) provide the specific reason detail alongside CARC 171 on the 835 electronic remittance. These are the RARCs seen most often with this CARC.
| RARC | Meaning |
|---|---|
| M97 | Not paid to practitioner when provided to patient in this place of service. Payment included in the reimbursement issued the facility. |
| N92 | This facility is not certified for digital mammography. |
| N110 | This facility is not certified for film mammography. |
| N121 | Medicare Part B does not pay for items or services provided by this type of practitioner for beneficiaries in a Medicare Part A covered Skilled Nursing Facility (SNF) stay. |
| N428 | Not covered when performed in this place of service. |
| N732 | Services performed at an unlicensed facility are not reimbursable. |
| N762 | This facility is not certified for Tomosynthesis (3-D) mammography. |
See the full resolution workflow for CARC 171
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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