RARC M27 Active Informational

RARC M27: Provider Liable for Waived Patient Charges

What This Means

The payer determined the services were not medically necessary or constituted custodial care, and the provider is responsible for all waived charges including coinsurance. Under the limitation of liability provision, the patient cannot be billed for these services. Review whether an Advance Beneficiary Notice (ABN) was obtained before the service to determine if liability can shift to the patient on future claims.

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

Commonly Paired With

RARC M27 commonly appears alongside these CARC denial codes:

Code Name
CO-108 Rent/Purchase Guidelines Not Met

Sources

  1. X12.org