We do not offer coverage for this type of service or the patient is not enrolled in this portion of our benefit package.
Code type
RARC (Remark)
Category
Patient Eligibility
Common CARC pairings
RARCs like N216 ride alongside CARCs on the 835 electronic remittance advice. These are the CARC denials RARC N216 is most often paired with.
| CARC | Meaning |
|---|---|
| 26 | Expenses incurred prior to coverage. |
| 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. |
| 109 | Claim/service not covered by this payer/contractor. You must send the claim/service to the correct payer/contractor. |
| 297 | Claim received by the medical plan, but benefits not available under this plan. Submit these services to the patient's vision plan for further consideration. |
| 300 | Claim received by the medical plan, but benefits not available under this plan. Claim has been forwarded to the patient's behavioral health plan for further consideration. |
| 301 | Claim received by the medical plan, but benefits not available under this plan Submit these services to the patient's behavioral health plan for further consideration. |
| 304 | Claim received by the medical plan, but benefits not available under this plan. Submit these services to the patient's hearing plan for further consideration. |
| B11 | The claim/service has been transferred to the proper payer/processor for processing. Claim/service not covered by this payer/processor. |
See the full resolution workflow for RARC N216
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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