RARC N115 Active Supplemental

RARC N115: Decision Based on National Coverage Determination

What This Means

The payer's decision on this claim was driven by a Medicare National Coverage Determination (NCD). NCDs are nationwide policies that specify whether Medicare covers a particular item or service. Review the applicable NCD to confirm coverage criteria were met, and if the service qualifies, resubmit with documentation demonstrating medical necessity under that NCD.

Disclaimer
This content is for informational purposes only. Always verify against your payer contracts and current coding guidelines.

Commonly Paired With

RARC N115 commonly appears alongside these CARC denial codes:

Code Name
CO-18 Exact Duplicate Claim or Service (also OA-18) →
PR-66 Blood Deductible (also CO-66) →
CO-70 Cost Outlier Adjustment →
CO-74 Indirect Medical Education Adjustment →
CO-75 Direct Medical Education Adjustment →
CO-76 Disproportionate Share Adjustment →
PR-85 Patient Interest Adjustment →
CO-151 Documentation Does Not Support Service Frequency →

Sources

  1. X12.org