CARC Code
194
Anesthesia by Operating Physician
The claim was denied because anesthesia was administered by the surgeon or attending physician performing the procedure, rather than by a separate anesthesia provider. Payers typically do not reimburse separately for anesthesia when it is performed by the same provider doing the surgery.
contractualHow to resolve this denial
Accept — anesthesia payment bundled per CMS rules for operating physician
- 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-194 — stats, related codes, appeal template
99%
Recovery Rate
1-3 days
Avg. Resolution
Easy
Difficulty
Rare
Frequency
Payer-Specific Notes
How major payers handle CARC 194 by specialty.
UnitedHealthcare
Review UHC's online claim status tool for additional detail on this adjustment.
Appeal Letter Template
Generic appeal template for CARC 194 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 194 indicating: "Anesthesia performed by operating physician, assistant surgeon, or attending phy." 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 →