CARC 189CO · Contractual Obligation
A generic 'unlisted procedure' code was used even though a specific code exists for this exact procedure.
- Common causes
- The biller wasn't aware a specific code existed, or used an unlisted code out of habit or uncertainty about the correct one.
- Suggested fix
- Identify and resubmit with the correct specific procedure code instead of the unlisted or not-otherwise-classified code.
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 189 mean?
A generic 'unlisted procedure' code was used even though a specific code exists for this exact procedure.
How do I resolve CARC 189?
Identify and resubmit with the correct specific procedure code instead of the unlisted or not-otherwise-classified code.
Why does CARC 189 happen?
The biller wasn't aware a specific code existed, or used an unlisted code out of habit or uncertainty about the correct one.
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.