CARC Code
179
Waiting Period Not Met
The claim was denied because the patient received services before completing a mandatory waiting period required by their insurance plan. The insurance policy requires a certain amount of time to pass before certain benefits become available.
eligibilityHow to resolve this denial
Verify correct procedure code; submit with applicable fee schedule or crosswalk code
- 1
Pull the original claim and review the denial reason and any RARC codes
- 2
Research the payer's policy for CARC 179 to understand the basis for denial
- 3
Gather supporting documentation addressing the denial reason
- 4
Submit a formal appeal with the documentation within the plan's appeal window
- 5
Follow up on the appeal within 30 days and document all communication
▶✓ 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-179 — stats, related codes, appeal template
82%
Recovery Rate
7-14 days
Avg. Resolution
Medium
Difficulty
Occasional
Frequency
Payer-Specific Notes
How major payers handle CARC 179 by specialty.
UnitedHealthcare
Review UHC's online claim status tool for additional detail on this adjustment.
Appeal Letter Template
Generic appeal template for CARC 179 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 179 indicating: "Applicable fee schedule does not contain the billed code.." 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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