What does CARC 241 mean?

CARC 241 means "Low Income Subsidy (LIS) Co-payment Amount.". The recommended action is: Request retroactive authorization; submit appeal with clinical documentation.

How do I resolve CARC 241?

Pull the original authorization request and approval (if any) Determine whether a retroactive authorization request is an option with this payer Prepare clinical documentation supporting medical necessity for the service Submit the retroactive authorization request through the payer portal Submit a formal appeal once the authorization is obtained or denied Document all communication with the payer in the patient account

Can CARC 241 be appealed?

CARC 241 has a 35% recovery rate and typically resolves in 21-45 days. Resolution difficulty is rated Hard.

CARC Code

241

🔴 Hard Denial

Low Income Subsidy (LIS) Co-payment Amount.

35%

Recovery Rate

21-45 days

Avg. Resolution

Hard

Difficulty

Common

Frequency

Recommended Action

Request retroactive authorization; submit appeal with clinical documentation

Step-by-Step Resolution

1
Pull the original authorization request and approval (if any)
2
Determine whether a retroactive authorization request is an option with this payer
3
Prepare clinical documentation supporting medical necessity for the service
4
Submit the retroactive authorization request through the payer portal
5
Submit a formal appeal once the authorization is obtained or denied
6
Document all communication with the payer in the patient account

Payer-Specific Notes

How major payers handle CARC 241 in practice.

MetLife Dental

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

Common 835 Combinations

CARC 241 most often appears with these Group Code + RARC combinations on 835 remittances.

COCO-241Appealable

Look up any combination →

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