CARC Code
249
Readmission Identified
The payer has determined that this admission is a readmission related to a previous stay and is applying contractual adjustment or denial based on their readmission policy. The provider is contractually responsible for the adjustment.
contractualHow to resolve this denial
Verify original claim was paid; void the duplicate or appeal if original was not paid
- 1
Pull the original claim and review the denial reason and any RARC codes
- 2
Research the payer's policy for CARC 249 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-249 — stats, related codes, appeal template
95%
Recovery Rate
3-7 days
Avg. Resolution
Easy
Difficulty
Occasional
Frequency
Payer-Specific Notes
How major payers handle CARC 249 by specialty.
UnitedHealthcare
Review UHC's online claim status tool for additional detail on this adjustment.
Appeal Letter Template
Generic appeal template for CARC 249 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 249 indicating: "This claim has been identified as a duplicate of a previously processed claim/se." 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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