RARC N115: This decision was based on a Local Coverage Determination (LCD).
Denial based on a Medicare Administrative Contractor's Local Coverage Determination.
What it means
The official X12 description: “This decision was based on a Local Coverage Determination (LCD).”
In plain language: Denial based on a Medicare Administrative Contractor's Local Coverage Determination.
What to do
Read the specific LCD cited. Appeal if patient meets LCD criteria or if LCD doesn't apply to this clinical situation. CMS LCD database: https://www.cms.gov/medicare-coverage-database
Frequently asked questions
What does RARC N115 mean?
This decision was based on a Local Coverage Determination (LCD). In plain language: Denial based on a Medicare Administrative Contractor's Local Coverage Determination.
What should I do when I see RARC N115?
Read the specific LCD cited. Appeal if patient meets LCD criteria or if LCD doesn't apply to this clinical situation. CMS LCD database: https://www.cms.gov/medicare-coverage-database
Commonly paired CARC codes
Sources
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