Denial Code Guidance
View the most common claim submission errors with a description, solutions, and ways to prevent these in the future.
- Remittance Advice Remark Codes (RARCs) are used to provide additional explanation for an adjustment already described by a CARC or to convey information about remittance processing.
- Claim Adjustment Reason Codes (CARCs) communicate an adjustment, meaning that they must communicate why a claim or service line was paid differently than it was billed. If there is no adjustment to a claim/line, then there is no adjustment reason code.
|Remark Code/Reason Code||Brief Description|
|M2 / 97||The beneficiary was inpatient on the date of service billed.|
|M3 M25 / 151||The item billed is same or similar to an item already received in the beneficiary's history.|
|M114 N565 / 4|| |
|M124 / 16||The item billed does not have the base equipment on file. The main equipment is missing therefore Medicare will not pay for supplies.|
|MA13 N264 N575 / 16||The item(s) billed did not have a valid ordering physician name.|
|MA13 N265 N276 / 16||The item(s) billed did not have a valid ordering physician National Provider Identifier (NPI) registered in Medicare Provider Enrollment, Chain and Ownership System (PECOS).|
|N102 / 50||The documentation requested was not received or was not received timely.|
|N104 / 109||The claim was submitted to the incorrect Jurisdiction.|
|N115 / 50|| |
|N115 / 151||There is a date span overlap or overutilization based on the related LCD.|
|N130 / 109||The claim was submitted to the incorrect contractor.|
|N130 / 204|| |
|N159 / 4||The HCPCS code is inconsistent with the modifier used or required modifier is missing.|
|N370 / A1||The oxygen equipment has exceeded the number of approved paid rentals.|
|N390 / 97||The HCPCS code billed is included in the payment/allowance for another service/procedure that has already been adjudicated|
|N418 / 109|| |
|N592 / 176||The item billed requires a recertified or revised Certificate of Medical Necessity (CMN) or DME Information Form (DIF) to be submitted. Either a CMN/DIF was not submitted or not on file with Noridian.|
|N668 / 173|| |
Last Updated Jun 08, 2016