Non-Covered Charge - JE Part B
Non-Covered Charge
| CARC/RARC | Description |
|---|---|
| CO-96 | Non-covered charge(s). Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. |
| N431 | Not covered with this procedure. |
Common Reasons for Message
- Non Covered Procedure Code (e.g. some ambulance, MolDX, etc.)
Next Step
- Review medical documentation to determine appropriate procedure code was submitted
- Submit Appeal request - Items or services with this message have appeal rights
- See Appeals webpage for instructions on how to submit a Reopening or Redetermination
Claim Submission Tips
- View Active LCDs to verify diagnosis codes that support medical necessity
Last Updated Dec 09 , 2023
