Service is not covered when patient is under age 45.
Code type
RARC (Remark)
Category
Coding
Common CARC pairings
RARCs like N906 ride alongside CARCs on the 835 electronic remittance advice. These are the CARC denials RARC N906 is most often paired with.
| CARC | Meaning |
|---|---|
| 6 | The procedure/revenue code is inconsistent with the patient's age. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| 9 | The diagnosis is inconsistent with the patient's age. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| 95 | Plan procedures not followed. |
| 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. |
| 256 | Service not payable per managed care contract. |
| 269 | Anesthesia not covered for this service/procedure. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| 272 | Coverage/program guidelines were not met. |
See the full resolution workflow for RARC N906
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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