This drug/service/supply is not included in the fee schedule or contracted/legislated fee arrangement.
Code type
RARC (Remark)
Category
Non-Covered Service
Common CARC pairings
RARCs like N448 ride alongside CARCs on the 835 electronic remittance advice. These are the CARC denials RARC N448 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. |
| 109 | Claim/service not covered by this payer/contractor. You must send the claim/service to the correct payer/contractor. |
| 185 | The rendering provider is not eligible to perform the service billed. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| 204 | This service/equipment/drug is not covered under the patient's current benefit plan. |
| 256 | Service not payable per managed care contract. |
See the full resolution workflow for RARC N448
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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