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

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

 

Last Updated Nov 15, 2017