The claim/service has been transferred to the proper payer/processor for processing. Claim/service not covered by this payer/processor.
Group code
CO, OA, PI or PR
Category
Benefit Maximum/Limitation
Risk level
Medium
Appealable
No
Common RARC pairings
RARCs (Remittance Advice Remark Codes) provide the specific reason detail alongside CARC B11 on the 835 electronic remittance. These are the RARCs seen most often with this CARC.
| RARC | Meaning |
|---|---|
| N216 | We do not offer coverage for this type of service or the patient is not enrolled in this portion of our benefit package. |
| N418 | Misrouted claim. See the payer's claim submission instructions. |
| N743 | Adjusted because the services may be related to an employment accident. |
| N744 | Adjusted because the services may be related to an auto/other accident. |
| N751 | Adjusted because the patient is covered under a Medicare Part D plan. |
| N904 | The transportation vendor is responsible for this claim. |
See the full resolution workflow for CARC B11
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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