What does CARC 62 mean?

CARC 62 means "Payment denied/reduced for absence of, or exceeded, pre-certification/authorization.". The recommended action is: Submit retroactive authorization request with clinical documentation.

How do I resolve CARC 62?

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 62 be appealed?

CARC 62 has a 35% recovery rate and typically resolves in 21-45 days. Resolution difficulty is rated Hard.

CARC Code

62

🔴 Hard Denial

Payment denied/reduced for absence of, or exceeded, pre-certification/authorization.

35%

Recovery Rate

21-45 days

Avg. Resolution

Hard

Difficulty

Common

Frequency

Recommended Action

Submit retroactive authorization request 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

Common Remark Codes (RARC)

These RARC codes often appear alongside CARC 62 on remittance advice.

RARC N673·Prior authorization is required for this service

→ Request retroactive authorization with clinical justification

Payer-Specific Notes

How major payers handle CARC 62 in practice.

MetLife Dental

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

Common 835 Combinations

CARC 62 most often appears with these Group Code + RARC combinations on 835 remittances.

COCO-62Appealable COCO-62+N285Appealable

Look up any combination →

Appeal Letter Template

Enter your email to access the full appeal template for CARC 62.

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 62 indicating: "Payment denied/reduced for absence of, or exceeded, precertification/authorizati." 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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