Payment adjustment based on the Merit-based Incentive Payment System (MIPS).
Code type
RARC (Remark)
Category
Plan Provision
Common CARC pairings
RARCs like N807 ride alongside CARCs on the 835 electronic remittance advice. These are the CARC denials RARC N807 is most often paired with.
| CARC | Meaning |
|---|---|
| 278 | Performance program proficiency requirements not met. (Use only with Group Codes CO or PI) Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
See the full resolution workflow for RARC N807
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.
Open in EDI Lab