140: Patient/Insured health identification number and name do not match.
The name submitted on the claim does not match the name associated with the member ID number in the payer's system. This is almost always a registration data-entry issue.
What the group code means
- CO
- Contractual Obligation. The provider is responsible and the amount cannot be billed to the patient.
- PI
- Payer Initiated Reduction. The payer considers the adjustment its own decision rather than a contract term.
This CARC is reported under more than one group code depending on the payer and the circumstances: CO, PI.
Why it fires
- A legal name change, such as from marriage or divorce, was not yet updated in registration or with the payer
- A typo in the first or last name, or the name entered in the wrong order, occurred during registration
- A dependent was billed under the subscriber's name or vice versa
Corrective actions, ranked
- 1
Compare to the insurance card
Verify the exact name as printed on the current insurance card against what was entered in the system.
- 2
Correct and resubmit
Fix the name field to match the payer's record and resubmit as a corrected claim.
- 3
Confirm the ID number
If the ID number itself may be wrong, such as transposed digits, re-verify eligibility with the corrected number.
Is it worth appealing
Not an appeal. This is a data correction, so fix the name or ID mismatch and resubmit rather than appealing.
Retrieved 2026-07-18.
Do not let this happen again
Scrub the claim against NCCI PTP and MUE edits before you submit, free and in your browser.
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.