We are not changing the prior payer's determination of patient responsibility, which you may collect, as this service is not covered by us.
Code type
RARC (Remark)
Category
Coordination of Benefits
Common CARC pairings
RARC N536 appears with a Claim Adjustment Reason Code (CARC) on the 835 electronic remittance advice and gives more detail about the adjustment. These are the CARCs most often paired with RARC N536.
| CARC | Meaning |
|---|---|
| 276 | Services denied by the prior payer(s) are not covered by this payer. |
See the full resolution workflow for RARC N536
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 requirements.
Open in EDI Lab