RARC M55: We do not pay for self-administered anti-emetic drugs that are not administered with a covered oral anti-cancer drug.
We do not pay for self-administered anti-emetic drugs that are not administered with a covered oral anti-cancer drug.
What it means
The official X12 description: “We do not pay for self-administered anti-emetic drugs that are not administered with a covered oral anti-cancer drug.”
In plain language: We do not pay for self-administered anti-emetic drugs that are not administered with a covered oral anti-cancer drug.
What to do
Read the accompanying CARC for the primary denial reason; this RARC adds detail. Appeal or correct based on the CARC's appealability.
Frequently asked questions
What does RARC M55 mean?
We do not pay for self-administered anti-emetic drugs that are not administered with a covered oral anti-cancer drug. In plain language: We do not pay for self-administered anti-emetic drugs that are not administered with a covered oral anti-cancer drug.
What should I do when I see RARC M55?
Read the accompanying CARC for the primary denial reason; this RARC adds detail. Appeal or correct based on the CARC's appealability.
Related
Sources
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