Denial code lookup

What does this CARC mean, and what do I do about it

Every CARC below is explained in plain English: why it fires, the ranked corrective actions, whether an appeal is worth filing, and the group code (CO, PR, OA, PI) that decides who owes the money. Every field cites the X12 source it came from.

50 CARC codes in this dataset, a curated and growing subset of the full X12 Claim Adjustment Reason Codes list. A code not listed here is not confirmed clean, it simply is not in our dataset yet.

Group code:

50 of 50 shown

Contractual Obligation. The provider is responsible and the amount cannot be billed to the patient.

Patient Responsibility. The amount may be billed to the patient.

Other Adjustment. Used when neither CO nor PR applies.

Payer Initiated Reduction. The payer considers the adjustment its own decision rather than a contract term.

Have a RARC too, or want to check the claim before you send it

Look up the remark code alongside the CARC, or scrub the claim against NCCI PTP and MUE edits before it ever reaches the payer.

Remark code lookup Scrub a claim

DenialPath provides billing and administrative guidance based on published CMS and X12 sources. It is not medical advice, not a coverage determination, and not a guarantee of payment. NCCI and MUE edits are republished quarterly and payer policies vary by contract. Always confirm against the payer's own current policy before submitting or appealing.