Patient did not meet the inclusion criteria for the demonstration project or pilot program.
Code type
RARC (Remark)
Category
Non-Covered Service
Common CARC pairings
RARC N564 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 N564.
| 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. |
| 272 | Coverage/program guidelines were not met. |
See the full resolution workflow for RARC N564
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