DenialCode.com
Free Healthcare Billing Reference

Medical Denial Code
Lookup Tool

Instantly find explanations, causes, and resolution steps for every Claim Adjustment Reason Code (CARC) and Remark Code.

Popular: CO-16 CO-45 PR-1 CO-29 CO-4 CO-45 Remark Code
4,524+
Denial Codes
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Group Code Types
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2024
Updated CARC List
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What Are Denial Codes?

Claim Adjustment Reason Codes (CARC) explain why a payment differs from what was billed. Every 835 ERA and EOB uses these standardized codes.

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How to Use This Tool

Search any code or keyword above. Each page includes the full description, common causes, resolution steps, and appeal guidance.

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Remark Codes Too

Each denial code page also links to a dedicated Remark Code page — optimized for providers searching for ERA remark code context.

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Appeal Your Denial

Most denials are reversible. Our guides walk you through the correct steps to correct, resubmit, or formally appeal each denial type.

Claim Adjustment Reason Codes
Showing 4,524 codes — click any code for full explanation and resolution steps
Code Description View
105Tax withholding. Start: 01/01/1995Details →
105Denied. Procedure code is incompatible with diagnosis code on the bill.Details →
106Incidental Incidental service(s) to primary procedure do not require separate reimbur…Details →
106Patient payment option/election not in effect. Start: 01/01/1995Details →
106Denied. The therapeutic class and the diagnosis on the bill are incompatible.Details →
107Obsolete or invalid procedure code Obsolete or invalid procedure codeDetails →
107The related or qualifying claim/service was not identified on this claim. Usage: Refe…Details →
107Board charges are allowed for payment of food items only. Other items are not authori…Details →
107The related or qualifying claim/service was not identified on this claim.Details →
108Multiple unit or multiple modifier denial. Multiple unit or multiple modifier denial.Details →
108Rent/purchase guidelines were not met. Usage: Refer to the 835 Healthcare Policy Iden…Details →
108Payment of this service has been authorized as a retraining expense.Details →
108The equipment is billed as a purchased item when only covered if rented.Details →
109Unilateral/Bilateral procedure code Unilateral/Bilateral procedure codeDetails →
109Claim/service not covered by this payer/contractor. You must send the claim/service t…Details →
109Deduction taken to reimburse L&I for unauthorized or excess payment of this service.Details →
109Claim was submitted to incorrect Jurisdiction Claim must be submitted to the Jurisdi…Details →
110Mutually exclusive Two or more procedure codes are considered mutually exclusive.Details →
110Billing date predates service date. Start: 01/01/1995Details →
110Paid technical component only. Professional component billed by and paid to another p…Details →
111Procedure does not require an Assistant Surgeon. Procedure does not require an Assist…Details →
111Not covered unless the provider accepts assignment. Start: 01/01/1995Details →
111The procedure modifier(s) required for the surgery(s) on this bill is either invalid …Details →
112Age range discrepancy Provider assigned an age-specific procedure to a patient whose …Details →
112Service not furnished directly to the patient and/or not documented. Start: 01/01/19…Details →
112Units of service adjusted to comply with the maximum 40 hours payable for this servic…Details →
113Gender discrepancy Provider assigned a gender-specific procedure to a patient of the …Details →
113Payment denied because service/procedure was provided outside the United States or as…Details →
113When billing an unlisted procedure code a specific description of service must be on …Details →
114Invalid diagnosis code Invalid diagnosis codeDetails →
114Procedure/product not approved by the Food and Drug Administration. Start: 01/01/199…Details →
114Paid. Condition not accepted but retarding recovery from accepted condition.Details →
115Procedure postponed, canceled, or delayed. Start: 01/01/1995 | Last Modified: 09/30/…Details →
115Units of service for accommodations conflict with the covered dates listed on your bi…Details →
116OPPS The services reported on this claim are not separately reimbursable under OPPS.Details →
116The advance indemnification notice signed by the patient did not comply with requirem…Details →
116No payment made for this surgical service. It is included in flat fee for major surge…Details →
117Incorrect blood Line items billing for blood and products is incorrect. Please resubm…Details →
117Transportation is only covered to the closest facility that can provide the necessary…Details →
117The 1st procedure code modifier is either completely invalid or invalid for the servi…Details →
118Radiopharm Certain nuclear medicine procedures are performed with specific diagnostic…Details →
118ESRD network support adjustment. Start: 01/01/1995 | Last Modified: 09/30/2007Details →
118This service has already been billed by and paid to another provider.Details →
119G0739 G0379 must be billed in conjunction with G0378.Details →
119Benefit maximum for this time period or occurrence has been reached. Start: 01/01/19…Details →
119Paid on adjunctive treatment basis only. Condition not accepted.Details →
119Item has met maximum limit for this time period. Payment already made for same/simila…Details →
120Inc in Part A The services billed on this claim are considered directly related to an…Details →
120Patient is covered by a managed care plan. Start: 01/01/1995 | Stop: 06/30/2007 Not…Details →
120Denied. The date of service is required. Submit bill only when service has been compl…Details →
121Need mod Component of comprehensive procedure that would be allowed if appropriate mo…Details →
121Indemnification adjustment - compensation for outstanding member responsibility. Sta…Details →
121Not paid. Provider name and/or number is missing or invalid.Details →
122T or S Medical visit on same day as a type T or S procedure without modifier 25.Details →
122Psychiatric reduction. Start: 01/01/1995Details →
122History adjustment due to consolidation of claim numbers.Details →
123Rev Code Please resubmit with corrected Revenue Code.Details →
123Payer refund due to overpayment. Start: 01/01/1995 | Stop: 06/30/2007 Notes: Refer …Details →
123Denied. This service is not payable in advance.Details →
124Mileage Mileage included in base rate.Details →

Understanding Medical Claim Denial Codes

Medical claim denial codes — formally known as Claim Adjustment Reason Codes (CARC) — are standardized identifiers maintained by the X12 standards body and used across all Medicare, Medicaid, and commercial payer 835 electronic remittance transactions. When a claim is paid at a different amount than billed, at least one CARC code must accompany the remittance advice to indicate the specific reason for the adjustment.

The most frequently encountered codes include CO-16 (missing or invalid claim information), CO-45 (charges exceeding fee schedule), PR-1 (patient deductible), CO-29 (timely filing deadline exceeded), and CO-4 (procedure code inconsistent with modifier). Each represents a distinct, actionable reason that has a defined resolution pathway.