CARC 172CO · Contractual Obligation
The payment amount was adjusted because of the rendering provider's specialty designation.
- Common causes
- Some payers apply different fee schedules or reductions based on the provider's specialty for certain services.
- Suggested fix
- Confirm the provider's specialty is correctly recorded with the payer and that the applicable fee schedule matches the contract.
Related Contractual Obligation codes
107This claim depends on another related claim or service being referenced, but that link wasn't provided.11The diagnosis code doesn't support medical necessity for the procedure billed, based on the payer's coverage edits.13The claim shows a date of service after the patient's recorded date of death.146The diagnosis code billed wasn't a valid, active code as of the date of service.150The documentation submitted doesn't justify the complexity or level of the service billed, commonly seen with evaluation and management visit levels.16The claim is missing required information or contains a billing error that prevented the payer from processing it.170This payer doesn't reimburse this specific provider type for this service.171This payer doesn't cover this service when it's billed by this provider type in this particular facility setting.
Frequently asked questions
What does CARC 172 mean?
The payment amount was adjusted because of the rendering provider's specialty designation.
How do I resolve CARC 172?
Confirm the provider's specialty is correctly recorded with the payer and that the applicable fee schedule matches the contract.
Why does CARC 172 happen?
Some payers apply different fee schedules or reductions based on the provider's specialty for certain services.
CARC codes maintained by X12 (x12.org). Descriptions on this site are original reference interpretations. Always verify codes with authoritative sources before making billing decisions.