This is a work-related injury/illness and thus the liability of the Worker's Compensation Carrier.
Group code
CO, PI or PR
Category
Coordination of Benefits
Risk level
High
Appealable
Review Required
Common RARC pairings
RARCs (Remittance Advice Remark Codes) provide the specific reason detail alongside CARC 19 on the 835 electronic remittance. These are the RARCs seen most often with this CARC.
| RARC | Meaning |
|---|---|
| N418 | Misrouted claim. See the payer's claim submission instructions. |
| N722 | Patient must use Workers' Compensation Set-Aside (WCSA) funds to pay for the medical service or item. |
| N728 | A workers' compensation insurer has reported having ongoing responsibility for medical services (ORM) for this diagnosis. |
See the full resolution workflow for CARC 19
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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