The referring provider is not eligible to refer the service billed. 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
Yes
Common RARC pairings
RARCs (Remittance Advice Remark Codes) provide the specific reason detail alongside CARC 183 on the 835 electronic remittance. These are the RARCs seen most often with this CARC.
| RARC | Meaning |
|---|---|
| N574 | Our records indicate the ordering/referring provider is of a type/specialty that cannot order or refer. Please verify that the claim ordering/referring provider information is accurate or contact the ordering/referring provider. |
| N630 | Referral not authorized by attending physician. |
| N767 | The Medicaid state requires provider to be enrolled in the member's Medicaid state program prior to any claim benefits being processed. |
| N799 | Submitted identifier must be an individual identifier, not group identifier. |
| N808 | Not covered for this provider type / provider specialty. |
See the full resolution workflow for CARC 183
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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