Paid at the regular rate as you did not submit documentation to justify the modified procedure code.
Code type
RARC (Remark)
Category
Medical Necessity
Common CARC pairings
RARC M69 appears with a Claim Adjustment Reason Code (CARC) on the 835 electronic remittance advice and gives more detail about the adjustment. These are the CARCs most often paired with RARC M69.
| CARC | Meaning |
|---|---|
| 151 | Payment adjusted because the payer deems the information submitted does not support this many/frequency of services. |
See the full resolution workflow for RARC M69
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 requirements.
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