Claim received by the medical plan, but benefits not available under this plan. Submit these services to the patient's hearing plan for further consideration.
Group code
CO, PI or PR
Category
Benefit Maximum/Limitation
Risk level
Medium
Appealable
Review Required
Common RARC pairings
RARCs (Remittance Advice Remark Codes) provide the specific reason detail alongside CARC 304 on the 835 electronic remittance. These are the RARCs seen most often with this CARC.
| RARC | Meaning |
|---|---|
| N130 | Consult plan benefit documents/guidelines for information about restrictions for this service. |
| N216 | We do not offer coverage for this type of service or the patient is not enrolled in this portion of our benefit package. |
| N658 | The billed service(s) are not considered medical expenses. |
See the full resolution workflow for CARC 304
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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