How do I resolve a CO-173 denial?

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 See full Medicare contractor resolution steps at tryarceum.com.

Can I appeal a CO-173 denial?

Yes. Most CO-173 denials can be appealed within 60-180 days depending on payer. This is appealable if a valid physician prescription exists but was not included with the original claim submission. Use our free tool to generate an appeal letter.

CARC Code

173

🔴 Hard Denial

No Physician Prescription

The claim was denied because the service or equipment provided was not prescribed by a physician. A valid physician prescription or order is required for coverage.

authorization

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-173 — 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 173 by specialty.

Blue Cross Blue Shield

BCBS requires appeal submission within 180 days for most plans.

Common 835 Combinations

CARC 173 most often appears with these Group Code + RARC combinations on 835 remittances.

COCO-173The payer denied this claim because the service or equipment was furnishedAppealable COCO-173+N668Service/equipment was not prescribed by a physician Incomplete/invalid

Look up any combination →

Appeal Letter Template

Generic appeal template for CARC 173 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 173 indicating: "No authorization obtained for telehealth services.." 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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