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
5
Group Code Types
Free
Always Free
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
M5Monthly rental payments can continue until the earlier of the 15th month from the fir…Details →
M5Monthly rental payments can continue until the earlier of the 15th month from the fir…Details →
M50Missing/incomplete/invalid revenue code(s).Details →
M50Missing/incomplete/invalid revenue code(s).Details →
M51Missing/incomplete/invalid procedure code(s).Details →
M51Claim/service lacks information or has submission/billing error(s) Missing/incomplet…Details →
M51Missing/incomplete/invalid procedure code(s).Details →
M52Missing/incomplete/invalid 'from' date(s) of service.Details →
M52Missing/incomplete/invalid 'from' date(s) of service.Details →
M53Missing/incomplete/invalid days or units of service.Details →
M53Missing/incomplete/invalid days or units of service.Details →
M54Missing/incomplete/invalid total charges.Details →
M54Missing/incomplete/invalid total charges.Details →
M55We do not pay for self-administered anti-emetic drugs that are not administered with …Details →
M55We do not pay for self-administered anti-emetic drugs that are not administered with …Details →
M56Missing/incomplete/invalid payer identifier.Details →
M56Missing/incomplete/invalid payer identifier.Details →
M57Missing/incomplete/invalid provider identifier.Details →
M57Missing/incomplete/invalid provider identifier.Details →
M58Missing/incomplete/invalid claim information. Resubmit claim after corrections.Details →
M58Missing/incomplete/invalid claim information. Resubmit claim after corrections.Details →
M59Missing/incomplete/invalid 'to' date(s) of service.Details →
M59Missing/incomplete/invalid 'to' date(s) of service.Details →
M6Alert: You must furnish and service this item for any period of medical need for the …Details →
M6Alert: You must furnish and service this item for any period of medical need for the …Details →
M60Missing Certificate of Medical Necessity.Details →
M60Claim/service lacks information or has submission/billing error(s) Missing Certifica…Details →
M60Missing Certificate of Medical Necessity.Details →
M61We cannot pay for this as the approval period for the FDA clinical trial has expired.Details →
M61We cannot pay for this as the approval period for the FDA clinical trial has expired.Details →
M62Missing/incomplete/invalid treatment authorization code.Details →
M62Missing/incomplete/invalid treatment authorization code.Details →
M63We do not pay for more than one of these on the same day.Details →
M63We do not pay for more than one of these on the same day.Details →
M64Missing/incomplete/invalid other diagnosis.Details →
M64Missing/incomplete/invalid other diagnosis.Details →
M65One interpreting physician charge can be submitted per claim when a purchased diagnos…Details →
M65One interpreting physician charge can be submitted per claim when a purchased diagnos…Details →
M66Our records indicate that you billed diagnostic tests subject to price limitations an…Details →
M66Our records indicate that you billed diagnostic tests subject to price limitations an…Details →
M67Missing/incomplete/invalid other procedure code(s).Details →
M67Missing/incomplete/invalid other procedure code(s).Details →
M68Missing/incomplete/invalid attending, ordering, rendering, supervising or referring p…Details →
M68Missing/incomplete/invalid attending, ordering, rendering, supervising or referring p…Details →
M69Paid at the regular rate as you did not submit documentation to justify the modified …Details →
M69Paid at the regular rate as you did not submit documentation to justify the modified …Details →
M7No rental payments after the item is purchased, returned or after the total of issued…Details →
M7No rental payments after the item is purchased, returned or after the total of issued…Details →
M70Alert: The NDC code submitted for this service was translated to a HCPCS code for pro…Details →
M70Alert: The NDC code submitted for this service was translated to a HCPCS code for pro…Details →
M71Total payment reduced due to overlap of tests billed.Details →
M71Total payment reduced due to overlap of tests billed.Details →
M72Did not enter full 8-digit date (MM/DD/CCYY).Details →
M72Did not enter full 8-digit date (MM/DD/CCYY).Details →
M73The HPSA/Physician Scarcity bonus can only be paid on the professional component of t…Details →
M73The HPSA/Physician Scarcity bonus can only be paid on the professional component of t…Details →
M74This service does not qualify for a HPSA/Physician Scarcity bonus payment.Details →
M74This service does not qualify for a HPSA/Physician Scarcity bonus payment.Details →
M75Multiple automated multichannel tests performed on the same day combined for payment.Details →
M75Multiple automated multichannel tests performed on the same day combined for payment.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.