How do I resolve a CO-151 denial?

Review claim submitted for frequency limits listed in LCD and Policy Article and either adjust amounts because of supplier liable or appeal claim with documentation to support medical need. A Redetermination request may be submitted with all relevant supporting documentation. Noridian encourages Redeterminations/Appeals be submitted using the Noridian Medicare Portal. Review applicable Local Coverage Determination (LCD), LCD Policy Article, and Documentation Checklists prior to submitting request. Noridian encourages Redeterminations be submitted using the Noridian Medicare Portal Review Medically Unlikely Edit (MUE) tool for maximum units of service that a provider would report under most circumstances for a single beneficiary on a single date of service. See full Medicare contractor resolution steps at tryarceum.com.

Can I appeal a CO-151 denial?

Yes. Most CO-151 denials can be appealed within 60-180 days depending on payer. This is appealable because it involves a documentation and medical necessity determination that can be challenged with additional supporting evidence. Use our free tool to generate an appeal letter.

CARC Code

151

🔴 Hard Denial

Frequency or Quantity Not Supported

The insurance company reduced or denied payment because the documentation you provided does not justify how often or how many times the service was performed. They believe the frequency or quantity billed is excessive based on the medical information submitted.

medical necessity

Resolution: 35%Hard difficulty21-45 days avg

How to resolve this denial

Which payer denied this claim?

▶✓ Pre-action checklist — verify before contacting the payer

Review the full remittance advice (ERA/EOB) for additional RARC codes that explain the denial.
Verify the claim was submitted with correct patient eligibility and benefit information.
Check if this denial applies to a specific line item or the entire claim.

▶More about CO-151 — stats, related codes, appeal template

35%

Recovery Rate

21-45 days

Avg. Resolution

Hard

Difficulty

Occasional

Frequency

Payer-Specific Notes

How major payers handle CARC 151 by specialty.

Blue Cross Blue Shield

BCBS requires appeal submission within 180 days for most plans.

Common 835 Combinations

CARC 151 most often appears with these Group Code + RARC combinations on 835 remittances.

COCO-151The payer has reduced or denied payment because the documentation submittedAppealable COCO-151+M3Item billed is same or similar to an item already received in beneficiary's COCO-151+N115Policy frequency limits may have been reached, per LCD There is a date span

Look up any combination →

Appeal Letter Template

Generic appeal template for CARC 151 denials.

We are submitting a formal appeal for claim [CLAIM_NUMBER] for patient [PATIENT_NAME], date of service [DOS]. This claim was denied/adjusted with CARC 151 indicating: "Payment adjusted — info does not support this length of service.." We have reviewed the claim and are providing the attached documentation to support reconsideration. [SUPPORTING_DOCUMENTATION]. Please reconsider payment per the terms of our contract.

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