Procedure/service was partially or fully furnished by another provider.
Group code
CO, PI or PR
Category
Plan Provision
Risk level
High
Appealable
Rarely
Common RARC pairings
RARCs (Remittance Advice Remark Codes) provide the specific reason detail alongside CARC B20 on the 835 electronic remittance. These are the RARCs seen most often with this CARC.
| RARC | Meaning |
|---|---|
| M86 | Service denied because payment already made for same/similar procedure within set time frame. |
| N10 | Adjustment based on the findings of a review organization/professional consult/manual adjudication/medical advisor/dental advisor/peer review. |
| N120 | Payment is subject to home health prospective payment system partial episode payment adjustment. Patient was transferred/discharged/ readmitted during payment episode. |
| N347 | Your claim for a referred or purchased service cannot be paid because payment has already been made for this same service to another provider by a payment contractor representing the payer. |
| N472 | Payment for this service has been issued to another provider. |
| N538 | A facility is responsible for payment to outside providers who furnish these services/supplies/drugs to its patients/residents. |
See the full resolution workflow for CARC B20
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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