RARC N657 Active Supplemental

RARC N657: Services Must Use Correct Procedural Code

What This Means

The claim was billed with a procedure code that does not accurately describe the services rendered. The payer requires resubmission with the most specific and appropriate CPT or HCPCS code. Cross-reference the services performed against current coding manuals, consult with the rendering provider if needed, correct the procedure code, and resubmit the claim.

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

Commonly Paired With

RARC N657 commonly appears alongside these CARC denial codes:

Code Name
CO-11 Diagnosis Inconsistent with Procedure (also OA-11) →
CO-50 Non-Covered Services / Medical Necessity Denial (also PR-50) →
CO-51 Pre-Existing Condition Exclusion →
CO-55 Experimental / Investigational Procedure →
CO-56 Procedure / Treatment Not Deemed Effective →
CO-58 Invalid Place of Service / Treatment Setting Mismatch →
CO-60 Outpatient Services Not Covered Near Inpatient Stay →
CO-61 Second Surgical Opinion Not Obtained →
CO-95 Plan Procedures Not Followed (also PR-95, OA-95) →
CO-186 Level of Care Change Adjustment →
CO-188 Product/Procedure Not Covered Unless FDA-Recommended →
CO-213 Physician Self-Referral Prohibition Violation →
CO-216 Review Organization Findings (also OA-216, PR-216) →
CO-226 Provider Information Not Provided or Incomplete →
PR-227 Patient/Insured Information Not Provided →
CO-228 Information Not Provided to Previous Payer (also PR-228, OA-228) →
PR-229 Medicare Partial Charge on 12X Bill Type →
CO-231 Mutually Exclusive Procedures on Same Day (also OA-231) →
CO-232 Institutional Transfer DRG Difference (also OA-232) →
CO-235 Sales Tax Not Reimbursable (also PR-235) →
CO-236 Incompatible Procedure/Modifier Combination (also OA-236) →
PR-238 Ineligible Coverage Period Reduction →
CO-239 Claim Spans Eligible and Ineligible Periods — Rebill (also OA-239) →
CO-240 Diagnosis Inconsistent with Birth Weight (also OA-240) →
PR-241 Low Income Subsidy Co-payment Adjustment (also CO-241) →
CO-242 Services Not Provided by Network Provider (also PR-242, OA-242) →
CO-243 Services Not Authorized by Network Provider (also PR-243, OA-243) →
CO-249 Claim Identified as Readmission →
CO-261 Procedure Inconsistent with Patient History (also OA-261) →
CO-269 Anesthesia Not Covered for This Service (also PR-269) →

Sources

  1. X12.org