CARC 177PR · Patient Responsibility
The patient doesn't currently meet the plan's eligibility criteria for this benefit.
- Common causes
- A waiting period hasn't been satisfied, or specific eligibility conditions, such as enrollment in a particular plan tier, haven't been met.
- Suggested fix
- Verify eligibility requirements and timing with the payer; if a waiting period applies, resubmit once it's satisfied, or bill the patient in the interim.
Related Patient Responsibility codes
1The billed amount was applied to the patient's plan deductible instead of being paid by the payer.119The patient has used up the maximum benefit allowed for this service within the applicable time period, such as an annual visit limit.167The specific diagnosis code(s) on this claim aren't covered under the patient's plan.187This amount was or should be paid from the patient's consumer-directed spending account, such as an HSA or FSA, rather than by the payer.2This portion of the claim represents the patient's coinsurance share, the percentage of the allowed amount they are responsible for under their plan.200The service date falls within a period when the patient's coverage had lapsed.201The patient is responsible for this amount under a legal set-aside arrangement, commonly seen in workers' compensation Medicare Set-Aside cases, rather than the payer.202This charge is for a personal comfort or convenience item or service that isn't covered by the plan.
Frequently asked questions
What does CARC 177 mean?
The patient doesn't currently meet the plan's eligibility criteria for this benefit.
How do I resolve CARC 177?
Verify eligibility requirements and timing with the payer; if a waiting period applies, resubmit once it's satisfied, or bill the patient in the interim.
Why does CARC 177 happen?
A waiting period hasn't been satisfied, or specific eligibility conditions, such as enrollment in a particular plan tier, haven't been met.
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.