The diagnosis is inconsistent with the patient's age. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Group code
CO, PI or PR
Category
Coding
Risk level
High
Appealable
Yes
Common RARC pairings
RARCs (Remittance Advice Remark Codes) provide the specific reason detail alongside CARC 9 on the 835 electronic remittance. These are the RARCs seen most often with this CARC.
| RARC | Meaning |
|---|---|
| M37 | Not covered when the patient is under age 35. |
| M82 | Service is not covered when patient is under age 50. |
| M89 | Not covered more than once under age 40. |
| N129 | Not eligible due to the patient's age. |
| N517 | Resubmit a new claim with the requested information. |
| N657 | This should be billed with the appropriate code for these services. |
| N906 | Service is not covered when patient is under age 45. |
See the full resolution workflow for CARC 9
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 requirements.
Open in EDI Lab