RARC N781 Active Informational

RARC N781: No Deductible Allowed for QMB Patient

What This Means

The patient is a Qualified Medicare Beneficiary (QMB) and federal law prohibits collecting Medicare cost-sharing amounts, including deductibles and coinsurance, from QMB patients. If any deductible was already collected from this patient, it must be refunded. Submit the deductible and coinsurance amounts to the patient's secondary payer, typically Medicaid, for reimbursement.

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

Commonly Paired With

RARC N781 commonly appears alongside these CARC denial codes:

Code Name
PR-1 Deductible Amount (also CO-1, OA-1)
CO-303 QMB Patient Responsibility Not Covered (also OA-303)

Sources

  1. X12.org