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RARC
N54
RARC
Authorization
Quick Facts
Code
N54
Type
RARC
Category
Authorization
Status
Active
Claim information is inconsistent with pre-certified/authorized services
What Does This Code Mean?
What was billed doesn’t match what was actually pre-certified or authorized.
Common Causes
- Different CPT code billed than what was authorized
- Date of service billed falls outside the authorized date range
Recommended Next Steps
- Compare the authorization details exactly against what was billed
- Correct and resubmit if it was a data mismatch, or appeal with an authorization amendment
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Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.