How do I resolve a CO-152 denial?

Obtain the complete medical record documenting the clinical need for the service Review the payer's LCD/NCD or coverage policy for the billed procedure See full resolution steps at tryarceum.com.

Can I appeal a CO-152 denial?

Yes. Most CO-152 denials can be appealed within 60-180 days depending on payer. This is a medical necessity denial that can be appealed by submitting additional documentation demonstrating that the length of service was appropriate and medically necessary. Use our free tool to generate an appeal letter.

CARC Code

152

🔴 Hard Denial

Length of Service Not Supported

The insurance company believes the documentation you submitted does not justify the duration or number of days/units of service billed. They need more evidence to show why the length of treatment was medically necessary.

medical necessity

Resolution: 35%Hard difficulty21-45 days avg

How to resolve this denial

Which payer denied this claim?

Submit appeal with clinical documentation supporting prescribed dosage

1
Obtain the complete medical record documenting the clinical need for the service
2
Review the payer's LCD/NCD or coverage policy for the billed procedure
3
Prepare a Letter of Medical Necessity from the treating physician
4
Submit a formal appeal with clinical records, the letter, and peer-reviewed literature
5
Track the appeal and follow up within 30 days

Resolve this denial →

▶✓ 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-152 — 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 152 by specialty.

Blue Cross Blue Shield

BCBS requires appeal submission within 180 days for most plans.

Appeal Letter Template

Generic appeal template for CARC 152 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 152 indicating: "Payer deems info does not support this dosage.." 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.

Generate a personalized appeal letter →

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