CARC Code
193
Appeal Denied - Original Decision Upheld
The payer reviewed your appeal or reconsideration request and determined that the original payment or denial decision was correct. No changes will be made to the claim payment.
contractualHow to resolve this denial
Accept — payer reviewed appeal and upheld original decision; consider second-level appeal
- 1
Review the remittance advice to confirm the adjustment amount is accurate
- 2
Verify the contractual write-off against your fee schedule
- 3
Post the adjustment to the patient account
- 4
Do not balance bill the patient for this contractual reduction
- 5
Document the adjustment in your billing system
▶✓ 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-193 — stats, related codes, appeal template
99%
Recovery Rate
1-3 days
Avg. Resolution
Easy
Difficulty
Occasional
Frequency
Payer-Specific Notes
How major payers handle CARC 193 by specialty.
UnitedHealthcare
Review UHC's online claim status tool for additional detail on this adjustment.
Common 835 Combinations
CARC 193 most often appears with these Group Code + RARC combinations on 835 remittances.
Appeal Letter Template
Generic appeal template for CARC 193 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 193 indicating: "Original payment decision is being maintained.." 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.
Need to resolve this denial?
Get a step-by-step resolution plan with payer-specific guidance and appeal letter generation.
Resolve this denial →