RARC N362 Active Supplemental

RARC N362: Days or Units Exceed Acceptable Maximum

What This Means

The number of days or units of service billed on this claim exceeds the payer's acceptable maximum for the procedure or service. This may result from a data entry error, incorrect unit calculation, or exceeding the benefit limit. Verify the units are correct, and if the higher quantity is clinically appropriate, submit an appeal with documentation supporting the medical necessity for the additional days or units.

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

Commonly Paired With

RARC N362 commonly appears alongside these CARC denial codes:

Code Name
PR-16 Missing Information or Billing Error (also OA-16) →
CO-29 Timely Filing Limit Expired →
CO-35 Lifetime Benefit Maximum Reached (also PR-35, OA-35) →
CO-49 Routine/Preventive Exam Not Covered (also PR-49, OA-49) →
CO-59 Multiple / Concurrent Procedure Payment Reduction →
CO-69 Day Outlier Amount →
CO-78 Non-Covered Days / Room Charge Adjustment (also PR-78, OA-78) →
CO-90 Ingredient Cost Adjustment →
CO-91 Dispensing Fee Adjustment →
CO-108 Rent/Purchase Guidelines Not Met →
CO-119 Benefit Maximum Reached →
CO-135 Interim Bills Cannot Be Processed →
PR-149 Lifetime Benefit Maximum Reached →
CO-153 Documentation Does Not Support Prescribed Dosage →
CO-154 Documentation Does Not Support Day's Supply of Medication/Supplies →
CO-173 Service/Equipment Not Prescribed by Physician (also OA-173) →
CO-174 Service Not Prescribed Prior to Delivery (also OA-174) →
CO-175 Incomplete Prescription (also OA-175) →
CO-176 Prescription Not Current (also OA-176) →
CO-198 Precertification/Authorization Limits Exceeded →
CO-222 Exceeds Contracted Maximum Units (also OA-222) →
OA-P10 Payment Reduced to Zero Pending Litigation →
OA-P11 P&C Claim Disposition Pending Litigation →
OA-P8 Claim Under Investigation →

Sources

  1. X12.org