Benefit limitation for the orthodontic active and/or retention phase of treatment.
Code type
RARC (Remark)
Category
Benefit Maximum/Limitation
Common CARC pairings
RARC N786 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 N786.
| CARC | Meaning |
|---|---|
| 119 | Benefit maximum for this time period or occurrence has been reached. |
| 149 | Lifetime benefit maximum has been reached for this service/benefit category. |
See the full resolution workflow for RARC N786
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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