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MA55 - Denial Journal
RARC

MA55

What This Code Means

Not covered as patient received medical health care services, automatically revoking his/her election to receive religious non-medical health care services.

Common Causes

  • Service falls under a specific plan exclusion
  • Benefit maximum or occurrence limit already reached
  • Wrong plan or benefit category billed

How to Resolve or Appeal

  1. Confirm the specific exclusion or limit that applies with the payer
  2. Check for secondary coverage that may pick up the balance
  3. Bill the patient per financial policy if the exclusion is confirmed accurate

More Denial Codes to Check

CARC CO-119 Benefit maximum for this time period or occurrence has been reached CARC CO-139 Contracted funding agreement — subscriber employed by the provider of services CARC CO-276 CARC PR-1 Deductible amount CARC CO-202 CARC CO-46 CARC PR-3 Co-payment amount RARC MA33 CARC CO-24 Charges covered under a capitation agreement/managed care plan CARC CO-B1 CARC CO-35 Lifetime benefit maximum has been reached RARC M140

Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.

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