How do I resolve CARC 236?

Review NCCI edits for the billed procedure combination Determine if a modifier is applicable to bypass the bundling edit (e.g., -59, XE, XS, XP, XU) Verify the procedures were performed independently and at separate sites/times If modifier is appropriate, resubmit with the correct modifier and documentation If bundled correctly, accept the reduction and adjust the claim balance

Can CARC 236 be appealed?

CARC 236 has a 55% recovery rate and typically resolves in 14-30 days. Resolution difficulty is rated Medium.

CARC Code

236

🔴 Hard Denial

This procedure or procedure/modifier combination is not compatible with another procedure or procedure/modifier combination provided on the same day according to the National Correct Coding Initiative or workers' compensation state regulations/fee schedule requirements.

55%

Recovery Rate

14-30 days

Avg. Resolution

Medium

Difficulty

Common

Frequency

Recommended Action

Review NCCI edits for the procedure combination; rebill with modifier or accept bundling

Step-by-Step Resolution

1
Review NCCI edits for the billed procedure combination
2
Determine if a modifier is applicable to bypass the bundling edit (e.g., -59, XE, XS, XP, XU)
3
Verify the procedures were performed independently and at separate sites/times
4
If modifier is appropriate, resubmit with the correct modifier and documentation
5
If bundled correctly, accept the reduction and adjust the claim balance

Common Remark Codes (RARC)

These RARC codes often appear alongside CARC 236 on remittance advice.

RARC N184·Rebundled by payer ClaimCheck or equivalent

→ Review NCCI edit; add modifier or accept bundling

Payer-Specific Notes

How major payers handle CARC 236 in practice.

MetLife Dental

MetLife provides detailed denial reason codes — check EOB for supplemental information.

Common 835 Combinations

CARC 236 most often appears with these Group Code + RARC combinations on 835 remittances.

COCO-236Appealable COCO-236+N184Appealable COCO-236+N104Appealable COCO-236+N610Appealable

Look up any combination →

Appeal Letter Template

Enter your email to access the full appeal template for CARC 236.

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 236 indicating: "Procedure or procedure/modifier combination is not compatible with another proce." 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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