Patient must use Workers' Compensation Set-Aside (WCSA) funds to pay for the medical service or item.
Code type
RARC (Remark)
Category
Coordination of Benefits
Common CARC pairings
RARC N722 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 N722.
| CARC | Meaning |
|---|---|
| 19 | This is a work-related injury/illness and thus the liability of the Worker's Compensation Carrier. |
| 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. |
| 201 | Patient is responsible for amount of this claim/service through 'set aside arrangement' or other agreement. (Use only with Group Code PR). 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.) |
See the full resolution workflow for RARC N722
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