RARC N95 Active Supplemental

RARC N95: Provider Type or Specialty Cannot Bill Service

What This Means

The provider's type or specialty is not authorized to bill for the service submitted on this claim. The billed service falls outside the scope of practice or payer contract for the provider classification on record. Verify that the correct provider type and specialty are on file with the payer, confirm the service is within scope for that classification, and rebill under the appropriate provider if needed.

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

Commonly Paired With

RARC N95 commonly appears alongside these CARC denial codes:

Code Name
CO-8 Procedure Inconsistent with Provider Specialty →
CO-12 Diagnosis Inconsistent with Provider Type →
CO-54 Multiple Physicians/Assistants Not Covered →
CO-111 Not Covered Unless Provider Accepts Assignment (also PR-111) →
CO-170 Payment Denied — Provider Type Not Eligible (also PR-170, OA-170) →
CO-171 Payment Denied — Provider Type in This Facility Type (also PR-171) →
CO-172 Provider Specialty Adjustment (also OA-172, PR-172) →
CO-193 Original Payment Decision Maintained →
CO-P12 Workers' Compensation Jurisdictional Fee Schedule Adjustment →
CO-P5 Reasonable and Customary Fee Adjustment (No Legislated Maximum) →

Sources

  1. X12.org