CARC Code
171
Wrong Provider or Facility Type
The claim was denied because the service was performed or billed by a type of provider or in a type of facility that is not allowed to perform or bill for this particular service. The insurance company's policy does not permit this combination of provider type, facility type, and service.
codingHow to resolve this denial
Add or correct the required modifier; verify NCCI rules and resubmit
- 1
Pull the original claim and review the specific field flagged by the RARC code
- 2
Compare claim data against the patient's insurance card and eligibility response
- 3
Correct the identified field(s) in the practice management system
- 4
Resubmit the corrected claim via the payer portal or clearinghouse
- 5
Confirm receipt and track the corrected claim to adjudication
▶✓ 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-171 — stats, related codes, appeal template
82%
Recovery Rate
7-14 days
Avg. Resolution
Medium
Difficulty
Common
Frequency
Payer-Specific Notes
How major payers handle CARC 171 by specialty.
UnitedHealthcare
Review UHC's online claim status tool for additional detail on this adjustment.
Common 835 Combinations
CARC 171 most often appears with these Group Code + RARC combinations on 835 remittances.
Appeal Letter Template
Generic appeal template for CARC 171 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 171 indicating: "Claim/service denied — procedure code inconsistent with modifier or required mod." 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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