Missing/incomplete/invalid HCPCS.
Code type
RARC (Remark)
Category
Coding
Common CARC pairings
RARCs like M20 ride alongside CARCs on the 835 electronic remittance advice. These are the CARC denials RARC M20 is most often paired with.
| CARC | Meaning |
|---|---|
| 4 | The procedure code is inconsistent with the modifier used. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| 16 | Claim/service lacks information or has submission/billing error(s). Usage: Do not use this code for claims attachment(s)/other documentation. 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.) Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| 181 | Procedure code was invalid on the date of service. |
See the full resolution workflow for RARC M20
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