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CARC — Claim Adjustment Reason Codes

CARCs appear in the 835 remittance advice CAS segment and tell you why the payer paid less than the billed amount — bundling, medical necessity, prior-auth gaps, timely-filing, patient responsibility, and contractual adjustments. 306 codes seeded, ordered by US search demand. Every leaf page cites the official X12 description and pairs the RARC partners typically observed on the 835. Source: X12 External Code Lists.

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Filter by root-cause category

All CARCs306Bundling / NCCI8Coding / modifier18Medical necessity8Prior authorization15Coverage / eligibility29Timely filing2Patient responsibility20Duplicate2Contractual21Other183

Showing 8 of 306 CARCs in Bundling / NCCI.

RankCodeDescription (X12)
#4CARC 97The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.
#8CARC B15This service/procedure requires that a qualifying service/procedure be received and covered. The qualifying other service/procedure has not been received/adjudicated.
#26CARC 59Processed based on multiple or concurrent procedure rules.
#76CARC B10Allowed amount has been reduced because a component of the basic procedure/test was paid. The beneficiary is not liable for more than the charge limit for the basic procedure/test.
#104CARC P14The Benefit for this Service is included in the payment/allowance for another service/procedure that has already been adjudicated.
#140CARC 128Newborn's services are covered in the mother's Allowance.
#155CARC 221Workers' Compensation claim adjudicated as non-compensable.
#279CARC P4Workers' Compensation claim adjudicated as non-compensable.

Tools for the reason codes in this directory

Bundling, unit and medical-necessity adjustments can be checked against CMS data before you work the denial.

Paired with a RARC?

Most CARCs arrive on the 835 alongside one or more Remittance Advice Remark Codes that narrow the reason. See the RARC remark-code reference for the paired explanations.

CARC Denial Codes List (2026) — Claim Adjustment Reason Codes | QuickIntell