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CARC 227 · CO-227

CARC 227 Denial: Information requested from the Billing/Rendering Provider was not provided or w… — How to Fix and Appeal

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Updated

TL;DR

CARC 227 (X12 Information requested from the Billing/Rendering Provider was not provided or was insufficient/incomplete). CARC 227 indicates the payer requested additional information from the billing or rendering provider and did not receive it (or received it but found it inadequate).

Official X12 description

“Information requested from the Billing/Rendering Provider was not provided or was insufficient/incomplete.”

Source: X12 Claim Adjustment Reason Codes. The X12 External Code Lists are the single authoritative source for every CARC descriptor — always verify against the current release before building a claim-scrub rule.

What CARC 227 actually means

CARC 227 indicates the payer requested additional information from the billing or rendering provider and did not receive it (or received it but found it inadequate). This is a 'records request timed out' denial — the cure is to identify the specific request, gather the documentation, and submit via the payer's preferred channel (ADR portal, fax, or mail) with the records-request letter attached.

Common root causes

  • An ADR (Additional Development Request) or records-request letter was sent and the response deadline passed.
  • Records were submitted but were illegible, incomplete, or for the wrong date of service.

Prevention checklist

  • Central ADR inbox monitored daily; every request logged with a due date and owner.
  • Quality-check responses before submission — right patient, right DOS, signature-dated, legible.

Appeal strategy — step by step

Most CARC 227 denials clear faster with the right remediation than with a formal appeal. Work the steps in order and escalate only when a lower-effort path has been ruled out.

  1. 1Gather the specific records the payer requested (op note, H&P, physician order, therapy notes) and submit via the payer's designated ADR channel with the original request letter.
  2. 2If the request was never received, appeal with mail-log or fax-log proof and resubmit the records.
Sample appeal-letter language for CARC 227
[Provider letterhead] Re: Appeal of CARC 227 — Claim #{claim_number} Member: {member_name} · Member ID: {member_id} Date(s) of Service: {dos} On {remittance_date} this claim was adjusted with CARC 227: "Information requested from the Billing/Rendering Provider was not provided or was insufficient/incomplete." We respectfully request reconsideration. The X12 External Code List definition of CARC 227 does not apply to this claim for the following reasons: 1. [Cite the clinical / coding / policy fact that rebuts the adjustment] 2. [Cite the supporting documentation attached — op note, EOB, LCD/NCD citation, NCCI edit indicator, modifier rationale] 3. [Cite the payer's own policy where applicable] Attached: {list supporting documents} Please process payment under the member's benefits. If additional information is required, contact the billing office at {provider_phone} or {provider_email}. Sincerely, {billing_manager_name}, {credentials}

Edit the bracketed fields before sending. This template is a starting point; a payer-specific appeal form may still be required — check the provider portal first.

Payer-specific notes

Payer-specific behavior for CARC 227 publishes here as the QuickIntell anonymized denial ETL ingests sufficient volume. In the meantime, consult the payer directory for the relevant provider manual and appeal form.

How common is CARC 227?

Search demand rank
#23

Out of 306 seeded CARCs, ranked by combined US monthly search volume for "CARC 227", "CO-227 denial", and "denial code 227".

Platform frequency
Pending ETL

Platform frequency ranks publish once the anonymized denial-rate pipeline reaches the publication threshold (strategy §12 Phase 2).

How QuickRCM prevents CARC 227

QuickRCM catches the root causes above before the 837 leaves the clearinghouse:

  • Claim-scrub rules fire on every root cause listed above — the scrub references the same X12 CAS segment logic that drives the denial, so what the payer checks, QuickRCM checks first.
  • When a denial lands, QuickRCM routes it to the correct worker with the documentation bundle already attached (op note, LCD citation, modifier rationale, EOB, primary 835).
  • Appeal templates tuned to each CARC (including this one) pull the supporting facts from the claim and fill the bracketed fields automatically.
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Frequently asked questions — CARC 227

What does CARC 227 mean?

CARC 227 is an X12 Claim Adjustment Reason Code. The official definition is: "Information requested from the Billing/Rendering Provider was not provided or was insufficient/incomplete." In plain English, the payer is telling you cARC 227 indicates the payer requested additional information from the billing or rendering provider and did not receive it (or received it but found it inadequate). This is a 'records request timed out' denial — the cure is to identify the specific request, gather the documentation, and submit via the payer's preferred channel (ADR portal, fax, or mail) with the records-request letter attached.

How do I resolve a CARC 227 (CO-227) denial?

Start with the most common root cause: An ADR (Additional Development Request) or records-request letter was sent and the response deadline passed. First step: Gather the specific records the payer requested (op note, H&P, physician order, therapy notes) and submit via the payer's designated ADR channel with the original request letter. See the full remediation and appeal checklist on this page before filing a formal appeal.

Is CARC 227 patient responsibility?

No — CARC 227 is typically carried under CO (Contractual Obligation) or OA (Other Adjustment), which means it is the provider's responsibility, not the patient's. Do not bill the patient unless the 835 CAS group code is PR.

What does CARC 227 look like on an EOB or 835 remittance?

On the 835 ERA, CARC 227 appears in Loop 2110 CAS segment as "CAS*CO*227*{amount}". On a paper EOB the same code prints in the Adjustment/Denial Reason column with the X12 description: "Information requested from the Billing/Rendering Provider was not provided or was insufficient/incomplete." — usually paired with one or more RARC remark codes in the same remittance line for additional context.

Which RARC is paired with CARC 227?

CARC 227 is commonly observed with RARC M127, N706, N26. The RARC narrows the reason — for example, pointing at a missing modifier, an LCD citation, or a specific policy. Fix the underlying CARC first; the RARC usually clears with the corrected claim.

Disclaimer

This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. X12 code descriptors are maintained by the X12 External Code Lists; always verify against the current X12 release and the payer's own published policy before submitting or appealing a claim.