CARC Code
5
The procedure code/type of bill is inconsistent with the place of service.
82%
Recovery Rate
7-14 days
Avg. Resolution
Medium
Difficulty
Common
Frequency
Recommended Action
Correct the place of service or procedure code and resubmit
Step-by-Step Resolution
- 1
Pull the original claim and review the specific field flagged by the RARC code
- 2
Compare claim data against the patient's insurance card and eligibility response
- 3
Correct the identified field(s) in the practice management system
- 4
Resubmit the corrected claim via the payer portal or clearinghouse
- 5
Confirm receipt and track the corrected claim to adjudication
Common Remark Codes (RARC)
These RARC codes often appear alongside CARC 5 on remittance advice.
→ Correct POS or procedure code
Payer-Specific Notes
How major payers handle CARC 5 in practice.
Delta Dental
Delta frequently returns CO-5 for ADA code and diagnosis mismatches. Verify code pairing.
Common 835 Combinations
CARC 5 most often appears with these Group Code + RARC combinations on 835 remittances.
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