RARCN122ReferenceCurrentVerified Aug 15, 2026

RARC N122

AR Guide Workflow

Coding & Modifiers

The payer identified a coding issue — a mismatched or missing modifier, an inconsistent diagnosis, a revenue-code mismatch, or an unbundled service.

Open denial workflow

AR Guide explanation

What it means

An add-on code cannot be billed by itself.

AR Guide knowledge

Common denial category

Coding & Modifiers — The payer identified a coding issue — a mismatched or missing modifier, an inconsistent diagnosis, a revenue-code mismatch, or an unbundled service.

AR Guide knowledge

Common usage

Coding denials for add-on codes billed without the primary procedure

About this guidance: Note

AR Guide knowledge is general reference content written by our team — it is not payer-specific policy and never replaces the payer’s documentation or your contract. Always confirm specifics with the payer.

Reference

Commonly paired CARCs

CARCs this remark commonly accompanies on the ERA/EOB, per the AR Guide pairing data.

CARC4The procedure code is inconsistent with the modifier used. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
CARC7The procedure/revenue code is inconsistent with the patient's gender. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
CARC11The diagnosis is inconsistent with the procedure. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
CARC12The diagnosis is inconsistent with the provider type. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
CARC97The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
CARC128Newborn's services are covered in the mother's Allowance.
CARC131Claim specific negotiated discount.
CARC199Revenue code and Procedure code do not match.
CARC232Institutional Transfer Amount. Usage: Applies to institutional claims only and explains the DRG amount difference when the patient care crosses multiple institutions.
CARC234This procedure is not paid separately. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)
CARC236This procedure or procedure/modifier combination is not compatible with another procedure or procedure/modifier combination provided on the same day according to the National Correct Coding Initiative or workers compensation state regulations/ fee schedule requirements.
CARC240The diagnosis is inconsistent with the patient's birth weight. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

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