Denials for JCode/NDC Combination, CR 115839

Mar 21, 2023

MaineCare has identified some pharmacy claim lines that denied in error for JCode/NDC missing or invalid due to a delay in the January 1, 2023, quarterly update from the Centers for Medicare & Medicaid Services (CMS). The Claims Adjustment Reason Code (CARC) and Remittance Advice Remark Code (RARC) are as follows. 

• CARC 16: Claim/service lacks information or has submission/billing error(s) 

• RARC M119: Missing/incomplete/invalid/deactivated/withdrawn National Drug Code (NDC). 

We will reprocess claims that denied in error and you do not need to take action.