Exceeds number/frequency approved/allowed within time period.
Code type
RARC (Remark)
Category
Non-Covered Service
Common CARC pairings
RARCs like N640 ride alongside CARCs on the 835 electronic remittance advice. These are the CARC denials RARC N640 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. |
| 119 | Benefit maximum for this time period or occurrence has been reached. |
| 150 | Payer deems the information submitted does not support this level of service. |
| 151 | Payment adjusted because the payer deems the information submitted does not support this many/frequency of services. |
| 152 | Payer deems the information submitted does not support this length of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| 198 | Precertification/notification/authorization/pre-treatment exceeded. |
| 222 | Exceeds the contracted maximum number of hours/days/units by this provider for this period. This is not patient specific. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| 273 | Coverage/program guidelines were exceeded. |
See the full resolution workflow for RARC N640
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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