Missing radiology report.
Code type
RARC (Remark)
Category
Medical Necessity
Common CARC pairings
RARCs like M31 ride alongside CARCs on the 835 electronic remittance advice. These are the CARC denials RARC M31 is most often paired with.
| CARC | Meaning |
|---|---|
| 50 | These are non-covered services because this is not deemed a 'medical necessity' by the payer. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| 163 | Attachment/other documentation referenced on the claim was not received. |
| 250 | The attachment/other documentation that was received was the incorrect attachment/document. The expected attachment/document is still missing. 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). |
| 252 | An attachment/other documentation is required to adjudicate this claim/service. 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). |
See the full resolution workflow for RARC M31
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.
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