Charges for outpatient services are not covered when performed within a period of time prior to or after inpatient services.
Group code
CO, PI or PR
Category
Documentation
Risk level
High
Appealable
Review Required
Common RARC pairings
RARCs (Remittance Advice Remark Codes) provide the specific reason detail alongside CARC 60 on the 835 electronic remittance. These are the RARCs seen most often with this CARC.
| RARC | Meaning |
|---|---|
| M114 | This service was processed in accordance with rules and guidelines under the DMEPOS Competitive Bidding Program or a Demonstration Project. For more information regarding these projects, contact your local contractor. |
| N130 | Consult plan benefit documents/guidelines for information about restrictions for this service. |
| N676 | Service does not qualify for payment under the Outpatient Facility Fee Schedule. |
| N806 | Payment is included in the Global transplant allowance. |
See the full resolution workflow for CARC 60
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.
Open in EDI Lab