Statutorily excluded service(s).
Code type
RARC (Remark)
Category
Non-Covered Service
Common CARC pairings
RARCs like N425 ride alongside CARCs on the 835 electronic remittance advice. These are the CARC denials RARC N425 is most often paired with.
| CARC | Meaning |
|---|---|
| 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. |
| 160 | Injury/illness was the result of an activity that is a benefit exclusion. |
| 283 | Attending provider is not eligible to provide direction of care. |
| B7 | This provider was not certified/eligible to be paid for this procedure/service on this date of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
See the full resolution workflow for RARC N425
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