Instantly find explanations, causes, and resolution steps for every Claim Adjustment Reason Code (CARC) and Remark Code.
Claim Adjustment Reason Codes (CARC) explain why a payment differs from what was billed. Every 835 ERA and EOB uses these standardized codes.
Search any code or keyword above. Each page includes the full description, common causes, resolution steps, and appeal guidance.
Each denial code page also links to a dedicated Remark Code page — optimized for providers searching for ERA remark code context.
Most denials are reversible. Our guides walk you through the correct steps to correct, resubmit, or formally appeal each denial type.
| Code | Description | View |
|---|---|---|
| 367 | The revenue code billed is invalid. | Details → |
| 368 | The charges for pain program services have been allowed as billed. | Details → |
| 369 | Transport/professional services rebill on CMS-1500. Others invalid or not authorized … | Details → |
| 369 | No OON Medicaid coverage for this benefit The benefit for this service is not covered… | Details → |
| 370 | Adjudicated per agreement/contract. | Details → |
| 370 | Code billed in excess of once per 90 period Report only once every 90 days per CPT. | Details → |
| 371 | Denied. Service must be billed as office call, which includes treatment of the day. | Details → |
| 371 | TOB 328 received with no matching claim in history | Details → |
| 372 | We have received information verifying that the service billed was not performed. | Details → |
| 372 | Invalid admin code Resubmit with appropriate administration code. | Details → |
| 373 | Denied. This drug requires prior authorization. For authorization call 1-888-443-6798… | Details → |
| 373 | Submit to ASH This claim is the responsibility of Bravo Health's Delegated Chiropract… | Details → |
| 374 | Full flat fee paid for major condition/procedure; lesser condition/procedure paid at … | Details → |
| 374 | Service paid previously to another provider. Payment Denied. Information on file indi… | Details → |
| 375 | Allowed as office call which includes care of the day per the Maximum Fee Schedule. | Details → |
| 375 | Incorrect Admission Source Please submit with correct Admission Source. | Details → |
| 376 | Paid previously to the injured worker. It is his/her responsibility to reimburse you … | Details → |
| 376 | CMS Noncovered ICD9/CPT Mods billed This claim has been denied for payment since it c… | Details → |
| 377 | Interest not allowed. Criteria for submission and/or bill data has not been met. | Details → |
| 377 | Resubmit proc code Please resubmit with a specific procedure code. | Details → |
| 378 | This bill does not meet the criteria established by L&I for interest payment. | Details → |
| 378 | Resubmit claim form Please resubmit claim on the correct claim form type. | Details → |
| 379 | This line item is for payment of interest. | Details → |
| 379 | Invalid ASC Code The service billed is not an approved ASC procedure. | Details → |
| 380 | Payment recouped/denied. Include non-therapy outpatient services on resubmitted inpat… | Details → |
| 380 | Invalid Date Span The "from" and "to" dates must be different. | Details → |
| 381 | This bill is not payable at this time. The claim is in abeyance pending further deter… | Details → |
| 381 | IB fax number Please fax bills to 1(877)-788-2764. | Details → |
| 382 | Denied. Incremental nursing charge rates must be billed with revenue code 23X. | Details → |
| 382 | Invalid DRG No DRG found for the codes used. | Details → |
| 383 | This line item deducted. Include charge on inpatient bill to be resubmitted L&I. | Details → |
| 383 | Invalid secondary diagnosis Invalid secondary diagnosis code. | Details → |
| 384 | Denied. The revenue code billed does not match the description of the services render… | Details → |
| 384 | Invalid discharge date Invalid discharge date. | Details → |
| 385 | Denied. Maximum allowed payment has already been made per contract or agreement. | Details → |
| 385 | Global day overlap Not reimbursable. Services rendered are within the global day bill… | Details → |
| 386 | Payment not made on this bill. This service(s) is duplicated on another bill in proce… | Details → |
| 386 | HHD isenroll This member disenrolled during the home health episode. A claim for a pa… | Details → |
| 387 | The original bill was correctly adjudicated/processed; an adjustment to it is not all… | Details → |
| 387 | BPHP previously paid The Bravo Personal Health Profile has already been reimbursed fo… | Details → |
| 388 | Additional payment for treatment to contiguous area is not allowed. | Details → |
| 388 | Claim cancelled Bill Type 118 received and claim was cancelled. | Details → |
| 389 | Procedure code changed to more closely reflect service indicated. Please note for fut… | Details → |
| 389 | Leave of Absence and Level of Care mismatch Leave of Absence and Level of Care cannot… | Details → |
| 390 | Denied. A report is required when billing for this service or procedure. | Details → |
| 390 | Service cannot be billed on same date as LOC Code cannot be billed without Level of C… | Details → |
| 391 | This is an adjustment to correct a previously adjudicated/processed bill. | Details → |
| 392 | Payment for this service has been made to the provider. Contact them for reimbursemen… | Details → |
| 393 | Services in this date span were previously paid. No substantiation for added charges … | Details → |
| 393 | Invalid Discharge Status Invalid Discharge Status | Details → |
| 394 | Denied. This service is not covered by L&I. Injured worker is responsible. | Details → |
| 395 | Time span for psychiatric exam not supplied on bill. Paid as one hour. | Details → |
| 396 | Payment delay caused by the use of the same procedure code for overlapping dates of s… | Details → |
| 397 | These charges have been included for payment and processed on another bill. | Details → |
| 398 | Denied. Invalid data entered in claim number field. | Details → |
| 399 | New incident unrelated to industrial injury. Bill injured worker on private non-indus… | Details → |
| 400 | There was no notification of this admit. The bill is referred to utilitzation review … | Details → |
| 401 | The provider master records indicate this provider number was terminated due to inval… | Details → |
| 402 | Denied. When billing this code, a description must be in remarks or on the bill. | Details → |
| 403 | Denied. Resubmit bill using your pain clinic provider number. | Details → |
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.