RARC M-Series Remark Codes

All 122 active RARC M-series Remittance Advice Remark Codes and their meanings. RARC codes supplement CARC denial reasons on the EOB/ERA. Search a code or keyword below.

X-ray not taken within the past 12 months or near enough to the start of treatment

Not paid separately when the patient is an inpatient

Equipment is the same or similar to equipment already being used

This is the last monthly installment payment for this durable medical equipment

Monthly rental payments can continue until the earlier of the 15th month from the first rental month, or the month when the equipment is no longer needed

You must furnish and service this item for any period of medical need for the remainder of the reasonable useful lifetime of the equipment

No rental payments after the item is purchased, returned or after the total of issued rental payments equals the purchase price

We do not accept blood gas tests results when the test was conducted by a medical supplier or taken while the patient is on oxygen

This is the tenth rental month. You must offer the patient the choice of changing the rental to a purchase agreement

M10

Equipment purchases are limited to the first or the tenth month of medical necessity

M11

DME, orthotics and prosthetics must be billed to the DME carrier who services the patient's zip code

M12

Diagnostic tests performed by a physician must indicate whether purchased services are included on the claim

M13

Only one initial visit is covered per specialty per medical group

M14

No separate payment for an injection administered during an office visit, and no payment for a full office visit if the patient only received an injection

M15

Separately billed services/tests have been bundled as they are considered components of the same procedure. Separate payment is not allowed

M16

Please see our web site, mailings, or bulletins for more details concerning this policy/procedure/decision

M17

Payment approved as you did not know, and could not reasonably have been expected to know, that this would not normally have been covered for this patient. In the future, you will…

M18

Certain services may be approved for home use. Neither a hospital nor a Skilled Nursing Facility is considered to be a patient's home

M19

Missing oxygen certification/re-certification

M20

Missing/invalid HCPCS

M21

Missing/invalid place of residence for this service/item provided in a home

M22

Missing/invalid number of miles traveled

M23

Missing invoice

M24

Missing/invalid number of doses per vial

M25

Coverage not supported for this level of service. Review/appeal may be requested within 120 days; patient refund/overpayment rules may apply.

M26

The information furnished does not substantiate the need for this level of service. If you have collected any amount from the patient for this level of service/any amount that exc…

M27

Coverage not supported for this level of service. Review/appeal may be requested within 120 days; patient refund/overpayment rules may apply.

M28

This does not qualify for payment under Part B when Part A coverage is exhausted or not otherwise available

M29

Missing operative note/report

M30

Missing pathology report

M31

Missing radiology report

M32

Conditional payment pending primary payer decision. Refund may be required if another payer later pays this service.

M36

This is the 11th rental month. We cannot pay for this until you indicate that the patient has been given the option of changing the rental to a purchase

M37

Not covered when the patient is under age 35

M38

Patient liable because written notice was given before service and patient agreed to be responsible.

M39

The patient is not liable for payment of this service as the advance notice of non-coverage you provided the patient did not comply with program requirements

M40

Claim must be assigned and must be filed by the practitioner's employer

M41

We do not pay for this as the patient has no legal obligation to pay for this

M42

The medical necessity form must be personally signed by the attending physician

M44

Missing/invalid condition code

M45

Missing/invalid occurrence code(s)

M46

Missing/invalid occurrence span code(s)

M47

Missing/invalid Payer Claim Control Number. Also called Internal Control Number, Claim Control Number, Document Control Number

M49

Missing/invalid value code(s) or amount(s)

M50

Missing/invalid revenue code(s)

M51

Missing/invalid procedure code(s)

M52

Missing/invalid 'from' date(s) of service

M53

Missing/invalid days or units of service

M54

Missing/invalid total charges

M55

We do not pay for self-administered anti-emetic drugs that are not administered with a covered oral anti-cancer drug

M56

Missing/invalid payer identifier

M59

Missing/invalid 'to' date(s) of service

M60

Missing Certificate of Medical Necessity

M61

We cannot pay for this as the approval period for the FDA clinical trial has expired

M62

Missing/invalid treatment authorization code

M64

Missing/invalid other diagnosis

M65

One interpreting physician charge can be submitted per claim when a purchased diagnostic test is indicated. Please submit a separate claim for each interpreting physician

M66

Our records indicate that you billed diagnostic tests subject to price limitations and the procedure code submitted includes a professional component. Only the technical component…

M67

Missing/invalid other procedure code(s)

M69

Paid at the regular rate as you did not submit documentation to justify the modified procedure code

M70

The NDC code submitted for this service was translated to a HCPCS code for processing, but please continue to submit the NDC on future claims for this item

M71

Total payment reduced due to overlap of tests billed

M73

The HPSA/Physician Scarcity bonus can only be paid on the professional component of this service. Rebill as separate professional and technical components

M74

This service does not qualify for a HPSA/Physician Scarcity bonus payment

M75

Multiple automated multichannel tests performed on the same day combined for payment

M76

Missing/invalid diagnosis or condition

M77

Missing/invalid/inappropriate place of service

M79

Missing/invalid charge

M80

Not covered when performed during the same session/date as a previously processed service for the patient

M81

You are required to code to the highest level of specificity

M82

Service is not covered when patient is under age 50

M83

Service is not covered unless the patient is classified as at high risk

M84

Medical code sets used must be the codes in effect at the time of service

M85

Subjected to review of physician evaluation and management services

M86

Service denied because payment already made for same/similar procedure within set time frame

M87

Claim/service(s) subjected to CFO-CAP prepayment review

M89

Not covered more than once under age 40

M90

Not covered more than once in a 12 month period

M91

Lab procedures with different CLIA certification numbers must be billed on separate claims

M93

Information supplied supports a break in therapy. A new capped rental period began with delivery of this equipment

M94

Information supplied does not support a break in therapy. A new capped rental period will not begin

M95

Services subjected to Home Health Initiative medical review/cost report audit

M96

Technical component for inpatient service can only be billed by the inpatient facility; bill only the professional component if applicable.

M97

Not paid to practitioner when provided to patient in this place of service. Payment included in the reimbursement issued the facility

M99

Missing/invalid Universal Product Number/Serial Number

M100

We do not pay for an oral anti-emetic drug that is not administered for use immediately before, at, or within 48 hours of administration of a covered chemotherapy drug

M102

Service not performed on equipment approved by the FDA for this purpose

M103

Break in therapy information affected coverage/payment determination for this item.

M104

Break in therapy information affected coverage/payment determination for this item.

M105

Break in therapy information affected coverage/payment determination for this item.

M107

Payment reduced as 90-day rolling average hematocrit for ESRD patient exceeded 36.5%

M109

We have provided you with a bundled payment for a teleconsultation. You must send 25 percent of the teleconsultation payment to the referring practitioner

M111

We do not pay for chiropractic manipulative treatment when the patient refuses to have an x-ray taken

M112

Reimbursement for this item is based on the single payment amount required under the DMEPOS Competitive Bidding Program for the area where the patient resides

M113

Our records indicate that this patient began using this item/service prior to the current contract period for the DMEPOS Competitive Bidding Program

M114

This service was processed in accordance with rules and guidelines under the DMEPOS Competitive Bidding Program or a Demonstration Project. For more information regarding these pr…

M115

This item is denied when provided to this patient by a non-contract or non-demonstration supplier

M116

Processed under a demonstration project or program. Project or program is ending and additional services may not be paid under this project or program

M117

Not covered unless submitted via electronic claim

M119

Missing/invalid/ deactivated/withdrawn National Drug Code

M121

We pay for this service only when performed with a covered cryosurgical ablation

M122

Missing/invalid level of subluxation

M123

Missing/invalid name, strength, or dosage of the drug furnished

M124

Missing indication of whether the patient owns the equipment that requires the part or supply

M125

Missing/invalid information on the period of time for which the service/supply/equipment will be needed

M126

Missing/invalid individual lab codes included in the test

M127

Missing patient medical record for this service

M129

Missing/invalid indicator of x-ray availability for review

M130

Missing invoice or statement certifying the actual cost of the lens, less discounts, and/or the type of intraocular lens used

M131

Missing physician financial relationship form

M132

Missing pacemaker registration form

M133

Claim did not identify who performed the purchased diagnostic test or the amount you were charged for the test

M134

Performed by a facility/supplier in which the provider has a financial interest

M135

Missing/invalid plan of treatment

M136

Missing/invalid indication that the service was supervised or evaluated by a physician

M137

Part B coinsurance under a demonstration project or pilot program

M138

Patient identified as a demonstration participant but the patient was not enrolled in the demonstration at the time services were rendered. Coverage is limited to demonstration pa…

M139

Denied services exceed the coverage limit for the demonstration

M141

Missing physician certified plan of care

M142

Missing American Diabetes Association Certificate of Recognition

M143

The provider must update license information with the payer

M144

Pre-/post-operative care payment is included in the allowance for the surgery/procedure

FAQ

What are RARC M-series codes?

RARC M-series codes are Remittance Advice Remark Codes that supplement a claim adjustment reason code (CARC) on the EOB/ERA with extra detail. This page lists all 122 active M-series codes and their meanings.

What is the difference between a CARC and a RARC?

A CARC states why a claim line was adjusted or denied; a RARC adds clarifying detail. A claim line can carry one CARC plus one or more RARCs.

← Back to the full denial codes lookup · CARC codes have individual pages; RARC are grouped by series. · POS codes

Reference only — CARC/RARC are national code sets updated periodically. Verify against the current official list before acting on a denial.