This item is denied when provided to this patient by a non-contract or non-demonstration supplier.
Code type
RARC (Remark)
Category
Non-Covered Service
Common CARC pairings
RARCs like M115 ride alongside CARCs on the 835 electronic remittance advice. These are the CARC denials RARC M115 is most often paired with.
| CARC | Meaning |
|---|---|
| 96 | Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| 184 | The prescribing/ordering provider is not eligible to prescribe/order the service billed. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| 242 | Services not provided by network/primary care providers. |
| 243 | Services not authorized by network/primary care providers. |
| 283 | Attending provider is not eligible to provide direction of care. |
| 299 | The billing provider is not eligible to receive payment for the service billed. |
See the full resolution workflow for RARC M115
Members of the EDI-Code Intelligence Lab get the step-by-step rework path, appeal language, root-cause drivers, and prevention checklist for every RARC and CARC pairing, plus payer-specific quirks.
Open in EDI Lab