This is not a covered service/procedure/ equipment/bed, however patient liability is limited to amounts shown in the adjustments under group 'PR'.
Code type
RARC (Remark)
Category
Non-Covered Service
Common CARC pairings
RARCs like N174 ride alongside CARCs on the 835 electronic remittance advice. These are the CARC denials RARC N174 is most often paired with.
| CARC | Meaning |
|---|---|
| 51 | These are non-covered services because this is a pre-existing condition. 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. |
| 289 | Services considered under the dental and medical plans, benefits not available. |
See the full resolution workflow for RARC N174
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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