Payment denied for exacerbation when treatment exceeds time allowed. To be used for Property and Casualty only.
Group code
CO, PI or PR
Category
P&C Guidelines
Risk level
Medium
Appealable
Review Required
Common RARC pairings
RARCs (Remittance Advice Remark Codes) provide the specific reason detail alongside CARC P31 on the 835 electronic remittance. These are the RARCs seen most often with this CARC.
| RARC | Meaning |
|---|---|
| N351 | Service date outside of the approved treatment plan service dates. |
| N370 | Billing exceeds the rental months covered/approved by the payer. |
| N435 | Exceeds number/frequency approved /allowed within time period without support documentation. |
| N640 | Exceeds number/frequency approved/allowed within time period. |
See the full resolution workflow for CARC P31
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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