How it works

RARCs begin with M, MA or N and accompany a CARC. Where the CARC gives the general reason, the RARC narrows it down — naming the missing or invalid field, the policy applied, or information the provider should know. Some RARCs are informational and do not describe a problem at all.

Why it matters

The same CARC is used for many different problems. CO 16, for example, only says that information is missing or wrong; the RARC beside it says which information. Working a denial without reading the RARC often leads to the wrong correction and a second denial.

Example

A claim is denied CO 16 with remark N290, indicating a missing or invalid rendering provider identifier. The fix is to correct the rendering provider’s NPI on the claim — or, if it was correct, to check the provider’s enrollment with that payer.