Claim processed in accordance with ambulatory surgical guidelines.
Code type
RARC (Remark)
Category
Billing
Common CARC pairings
RARCs like MA109 ride alongside CARCs on the 835 electronic remittance advice. These are the CARC denials RARC MA109 is most often paired with.
| CARC | Meaning |
|---|---|
| 5 | The procedure code/type of bill is inconsistent with the place of service. 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. |
| 97 | The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| 169 | Alternate benefit has been provided. |
See the full resolution workflow for RARC MA109
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