This procedure is not paid separately. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)
Group code
CO, PI or PR
Category
Bundling
Risk level
Medium
Appealable
Rarely
Common RARC pairings
RARCs (Remittance Advice Remark Codes) provide the specific reason detail alongside CARC 234 on the 835 electronic remittance. These are the RARCs seen most often with this CARC.
| RARC | Meaning |
|---|---|
| M2 | Not paid separately when the patient is an inpatient. |
| M14 | No separate payment for an injection administered during an office visit, and no payment for a full office visit if the patient only received an injection. |
| M15 | Separately billed services/tests have been bundled as they are considered components of the same procedure. Separate payment is not allowed. |
| M80 | Not covered when performed during the same session/date as a previously processed service for the patient. |
| N20 | Service not payable with other service rendered on the same date. |
| N67 | Professional provider services not paid separately. Included in facility payment under a demonstration project. Apply to that facility for payment, or resubmit your claim if: the facility notifies you the patient was excluded from this demonstration; or if you furnished these services in another location on the date of the patient's admission or discharge from a demonstration hospital. If services were furnished in a facility not involved in the demonstration on the same date the patient was discharged from or admitted to a demonstration facility, you must report the provider ID number for the non-demonstration facility on the new claim. |
| N83 | No appeal rights. Adjudicative decision based on the provisions of a demonstration project. |
| N122 | Add-on code cannot be billed by itself. |
See the full resolution workflow for CARC 234
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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