Services denied by the prior payer(s) are not covered by this payer.
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 276 on the 835 electronic remittance. These are the RARCs seen most often with this CARC.
| RARC | Meaning |
|---|---|
| N536 | We are not changing the prior payer's determination of patient responsibility, which you may collect, as this service is not covered by us. |
See the full resolution workflow for CARC 276
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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