CARC Code

158

🟡 Soft Denial

Service Provided Outside United States

The claim was denied because the medical service or procedure was performed in a location outside of the United States. Most U.S.-based insurance plans do not cover care received internationally.

contractual
Resolution: 82%Medium difficulty7-14 days avg

How to resolve this denial

Correct value code data on UB-04 and resubmit

  1. 1

    Pull the original claim and review the specific field flagged by the RARC code

  2. 2

    Compare claim data against the patient's insurance card and eligibility response

  3. 3

    Correct the identified field(s) in the practice management system

  4. 4

    Resubmit the corrected claim via the payer portal or clearinghouse

  5. 5

    Confirm receipt and track the corrected claim to adjudication

Resolve this denial →
✓ Pre-action checklist — verify before contacting the payer
  1. Review the full remittance advice (ERA/EOB) for additional RARC codes that explain the denial.

  2. Verify the claim was submitted with correct patient eligibility and benefit information.

  3. Check if this denial applies to a specific line item or the entire claim.

More about CO-158 — stats, related codes, appeal template

82%

Recovery Rate

7-14 days

Avg. Resolution

Medium

Difficulty

Rare

Frequency

Payer-Specific Notes

How major payers handle CARC 158 by specialty.

UnitedHealthcare

Review UHC's online claim status tool for additional detail on this adjustment.

Appeal Letter Template

Generic appeal template for CARC 158 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 158 indicating: "Payment adjusted — payer deems submitted value code data incorrect.." 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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