The following changes to the RARC and CARC codes will be effective April 1, 2009.
New Codes – CARC:
| Code |
Current Narrative |
Effective Date |
| 226 |
Information requested from the Billing/Rendering Provider was not provided or was insufficient/incomplete. At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason code.) |
9/21/2008 |
| 227 |
Information requested from the patient/insured/responsible party was not provided or was insufficient/incomplete. At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code.) |
9/21/2008 |
Modified Codes – CARC:
| Code |
Current Modified Narrative |
| 148 |
Information requested from the Billing/Rendering Provider was not provided or was insufficient/incomplete. At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason code.) |
Deactivated Codes – CARC:
| Code |
Current Narrative |
Effective Date |
| 17 |
Requested information was not provided or was insufficient/incomplete. At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code.) |
7/1/2009 |
| B18 |
This procedure code and modifier were invalid on the date of service. |
3/1/2009 |
New Codes – RARC:
| Code |
Current Narrative |
Medicare Initiated? |
| N505 |
Alert: This response includes only services that could be estimated in real time. No estimate will be provided for the services that could not be estimated in real time. |
No |
| N506 |
Alert: This is an estimate of the member’s liability based on the information available at the time the estimate was processed. Actual coverage and member liability amounts will be determined when the claim is processed. This is not a pre-authorization or a guarantee of payment. |
No |
| N507 |
Plan distance requirements have not been met. |
No |
| N508 |
Alert: This real time claim adjudication response represents the member responsibility to the provider for services reported. The member will receive an Explanation of Benefits electronically or in the mail. Contact the insurer if there are any questions. |
No |
| N509 |
Alert: A current inquiry shows the member’s Consumer Spending Account contains sufficient funds to cover the member liability for this claim/service. Actual payment from the Consumer Spending Account will depend on the availability of funds and determination of eligible services at the time of payment processing. |
No |
| N510 |
Alert: A current inquiry shows the member’s Consumer Spending Account does not contain sufficient funds to cover the member’s liability for this claim/service. Actual payment from the Consumer Spending Account will depend on the availability of funds and determination of eligible services at the time of payment processing. |
No |
| N511 |
Alert: Information on the availability of Consumer Spending Account funds to cover the member liability on this claim/service is not available at this time. |
No |
| N515 |
Alert: Submit this claim to the patient’s other insurer for potential payment of supplemental benefits. We did not forward the claim information. |
Yes |
