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CARC Code Reference

CARC 58: Treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

Group code CO, PI or PR
Category Provider/Facility Eligibility
Risk level High
Appealable Review Required

Common RARC pairings

RARCs (Remittance Advice Remark Codes) provide the specific reason detail alongside CARC 58 on the 835 electronic remittance. These are the RARCs seen most often with this CARC.

RARCMeaning
N87 Home use of biofeedback therapy is not covered.
N115 This decision was based on a Local Coverage Determination (LCD). An LCD provides a guide to assist in determining whether a particular item or service is covered. A copy of this policy is available at www.cms.gov/mcd, or if you do not have web access, you may contact the contractor to request a copy of the LCD.
N386 This decision was based on a National Coverage Determination (NCD). An NCD provides a coverage determination as to whether a particular item or service is covered. Visit CMS.gov and search for Medicare Coverage Database to find a copy of the policy.
N732 Services performed at an unlicensed facility are not reimbursable.
N760 This facility is not authorized to receive payment for the service(s).

See the full resolution workflow for CARC 58

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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