CARC 185CO · Contractual Obligation
The provider who performed the service isn't recognized by the payer as eligible to bill for it.
- Common causes
- The rendering provider isn't credentialed or enrolled with the payer, or their license or certification doesn't cover this service type.
- Suggested fix
- Verify the rendering provider's enrollment and credentialing status with the payer; correct the claim or complete credentialing as needed.
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 185 mean?
The provider who performed the service isn't recognized by the payer as eligible to bill for it.
How do I resolve CARC 185?
Verify the rendering provider's enrollment and credentialing status with the payer; correct the claim or complete credentialing as needed.
Why does CARC 185 happen?
The rendering provider isn't credentialed or enrolled with the payer, or their license or certification doesn't cover this service type.
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.