Not covered more than once under age 40.
Code type
RARC (Remark)
Category
Coding
Common CARC pairings
RARCs like M89 ride alongside CARCs on the 835 electronic remittance advice. These are the CARC denials RARC M89 is most often paired with.
| CARC | Meaning |
|---|---|
| 9 | The diagnosis is inconsistent with the patient's age. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| 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. |
| 119 | Benefit maximum for this time period or occurrence has been reached. |
| 256 | Service not payable per managed care contract. |
| 269 | Anesthesia not covered for this service/procedure. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
See the full resolution workflow for RARC M89
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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