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 |
|---|---|---|
| 900 | Payment has been made to a payee holding a lien. | Details → |
| 901 | Payment is received as the result of a lien. | Details → |
| 902 | Service(s) covered, but patient has received funds from third party and is responsibl… | Details → |
| 903 | Action is being taken. Do not send rebill, adjustment or appeal until you receive not… | Details → |
| 904 | Repayment of adjustment/deduction on bill(s) which refund/returned L&I warrant was re… | Details → |
| 905 | Denied. Submit adjustment with copy of invoice showing your cost for drugs/supplies a… | Details → |
| 906 | This adjustment is the result of an independent audit of charges for this hospitaliza… | Details → |
| 907 | Flat fee adjusted. After care charges paid to transfer physician. | Details → |
| 908 | Denied. Service is included in flat fee. | Details → |
| 909 | Service balance was previously paid in this claim or a related claim for this injured… | Details → |
| 910 | Bill adjusted. There was an error in your computation. | Details → |
| 911 | This service was paid on a diagnostic basis only. | Details → |
| 912 | Adjusted charge. Unlisted fee set by L&I allowed. | Details → |
| 913 | Consultation fee paid; treatment fees paid only to the attending physician. | Details → |
| 914 | Reopening exam and application paid; claim remains closed. | Details → |
| 915 | Rebill physician professional fees on CMS-1500 with CPT-4 service codes. | Details → |
| 916 | Denied. Multiple procedures/diagnoses/dates in a line item cannot be processed. Rebil… | Details → |
| 917 | Denied. Wrong diagnosis or procedure code used for the described condition or service… | Details → |
| 918 | Report/documentation submitted does not justify the code and/or fee billed. | Details → |
| 919 | Denied. Multiple claim numbers on one bill cannot be processed. Rebill separately. | Details → |
| 920 | Denied. The procedure code and/or report indicate the service was for an unrelated co… | Details → |
| 921 | Denied. Crime victim claim. Your bill has been forwarded to the Crime Victim Compensa… | Details → |
| 922 | Denied. Reopening application not received. | Details → |
| 923 | Denied. This is a self-insured claims. Submit bill to the employer. | Details → |
| 924 | Bill paid. You must reimburse the injured worker the total amount he/she paid for thi… | Details → |
| 925 | Adjusted in accordance with L&I's published fee schedule. | Details → |
| 926 | Professional fee adjusted to current L&I rate. | Details → |
| 927 | Balance paid separately under different claim number or different fund. | Details → |
| 928 | Denied. Attach copy of your receipt to copy of this statement and send to L&I. | Details → |
| 929 | Denied. Only payable when you must travel more than 10 miles one way. | Details → |
| 930 | Denied. Only authorized travel over 10 miles 1 way to nearest available treatment is … | Details → |
| 931 | Medical travel expense not payable when residence is over 50 miles from the Washingto… | Details → |
| 932 | Denied. The authorized distance traveled does not justify payment for lodging. | Details → |
| 933 | Denied. Emergency room report required. | Details → |
| 934 | As many items as possible have been processed on your bill. Rebill unprocessed servic… | Details → |
| 935 | Denied. This is a duplicate charge. | Details → |
| 936 | Processed using the injured worker's name that L&I has listed for this claim number. | Details → |
| 937 | You have used the wrong bill form for this service. Bill on proper bill form in the f… | Details → |
| 938 | Denied. Justification required for more than one round trip travel on same day. | Details → |
| 939 | Denied. Rebill or submit copy of remittance advice (circle ICN number). Attach requir… | Details → |
| 940 | Adjusted. Travel expense allowed to the nearest point of available treatment. | Details → |
| 941 | Denied. These services were paid by a private insurance carrier whom we have reimburs… | Details → |
| 942 | Denied. Provider is not the attending physician of record. This service is not author… | Details → |
| 943 | Denied. This injection is paid only in hospital setting for treatment of burns or fra… | Details → |
| 944 | This service paid on a diagnostic basis only. Treatment of the condition is denied. | Details → |
| 945 | Denied. This service is not payable in addition to an extensive or comprehensive offi… | Details → |
| 946 | Denied. Emergency room calls for scheduled drugs for treatment of chronic pain are no… | Details → |
| 947 | Bill paid in summary detail. All future bills must show only one date of service per … | Details → |
| 948 | Remainder of bill processed separately due to computer system limitations. | Details → |
| 949 | Payment for pharmacy made this time. Future bills must be submitted with code 99070 f… | Details → |
| 950 | Denied. When an injured worker is placed on pension L&I cannot pay schedule I,II,III,… | Details → |
| 951 | Time units must be billed as whole units. Please check your Fee Schedule and bill acc… | Details → |
| 952 | Processing 80 per cent of the interim payment requested. | Details → |
| 953 | Denied. Service was prior to approved training plan start date. | Details → |
| 954 | Denied. There are no funds approved for this procedure code. Contact vocational couns… | Details → |
| 955 | These services were paid by a hand warrant. | Details → |
| 956 | Reopening examination and application paid. Claim reopening is under consideration. | Details → |
| 957 | This is a deduction from the interim payment. | Details → |
| 958 | Adjusted. Mileage allowed based on number of miles by shortest direct route only. | Details → |
| 959 | Denied or adjusted. The per diem rate allowed includes lodging and meals for the day. | 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.