The attachment/other documentation that was received was incomplete or deficient. The necessary information is still needed to process the claim. 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 or PI
Category
Documentation
Risk level
High
Appealable
Yes
Common RARC pairings
RARCs (Remittance Advice Remark Codes) provide the specific reason detail alongside CARC 251 on the 835 electronic remittance. These are the RARCs seen most often with this CARC.
| RARC | Meaning |
|---|---|
| M42 | The medical necessity form must be personally signed by the attending physician. |
| M135 | Missing/incomplete/invalid plan of treatment. |
| MA04 | Secondary payment cannot be considered without the identity of or payment information from the primary payer. The information was either not reported or was illegible. |
| MA75 | Missing/incomplete/invalid patient or authorized representative signature. |
| MA81 | Missing/incomplete/invalid provider/supplier signature. |
| MA88 | Missing/incomplete/invalid insured's address and/or telephone number for the primary payer. |
| MA111 | Missing/incomplete/invalid purchase price of the test(s) and/or the performing laboratory's name and address. |
| N4 | Missing/Incomplete/Invalid prior Insurance Carrier(s) EOB. |
See the full resolution workflow for CARC 251
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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