Electronic Claim Submission Requirement

CARC/RARC Description
CO-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.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
M117 Not covered unless submitted via electronic claim.

 

Common Reasons for Message

  • Claim was submitted on paper CMS-1500 Claim Form but provider is required to submit electronic claims

Next Step

  • Resubmit claim electronically

Claim Submission Tips

  • Verify ability to submit paper claims
  • If individual provider is part of a group with an electronic claim submission requirement, then all members of group must submit electronically
  • Apply for an exemption to electronic claim submission: Administrative Simplification Compliance Act Enforcement

View reason code list, return to Reason Code Guidance page.

 

Last Updated May 21, 2018