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Code type
RARC (Remark)
Category
Coding
Common CARC pairings
RARCs like MA130 ride alongside CARCs on the 835 electronic remittance advice. These are the CARC denials RARC MA130 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. |
| 8 | The procedure code is inconsistent with the provider type/specialty (taxonomy). Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| 10 | The diagnosis is inconsistent with the patient's gender. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| 11 | The diagnosis is inconsistent with the procedure. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| 31 | Patient cannot be identified as our insured. |
| 129 | Prior processing information appears incorrect. 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.) |
| 140 | Patient/Insured health identification number and name do not match. |
| 284 | Precertification/authorization/notification/pre-treatment number may be valid but does not apply to the billed services. |
See the full resolution workflow for RARC MA130
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