Claims & denials · Definition
CARC / RARC: Definition
The standardized codes on a remittance that state why a claim was reduced or denied.
This is a short definition only. The full explanation lives on the dermatology denial code index, which is the page to read if you are dealing with this on live claims.
Definition
Also known as: Claim adjustment reason code / remittance advice remark code
CARC gives the adjustment reason; RARC adds the specific detail.
Reading them together is what distinguishes a fixable denial from a contractual adjustment that should never have been posted as a denial.
For worked examples, payer rules and documentation requirements, read the dermatology denial code index. Return to the dermatology billing glossary.
See this term in your own numbers
A free claims audit reviews a de-identified sample of your dermatology claims and returns a line-item findings report.