Medical provider not authorized/certified to provide treatment to injured workers in this jurisdiction.
Code type
RARC (Remark)
Category
Credentialing/Enrollment
Common CARC pairings
RARC N612 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 N612.
| CARC | Meaning |
|---|---|
| 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. |
| P4 | Workers' Compensation claim adjudicated as non-compensable. This Payer not liable for claim or service/treatment. Usage: If adjustment is at the Claim Level, the payer must send and the provider should refer to the 835 Insurance Policy Number Segment (Loop 2100 Other Claim Related Information REF qualifier 'IG') for the jurisdictional regulation. If adjustment is at the Line Level, the payer must send and the provider should refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment information REF). To be used for Workers' Compensation only |
See the full resolution workflow for RARC N612
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.
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