CARC 190CO · Contractual Obligation
This charge is already covered by the per-diem payment for the patient's skilled nursing facility stay and isn't paid separately.
- Common causes
- Skilled nursing facility consolidated billing rules bundle many ancillary services into the facility's per-diem rate.
- Suggested fix
- Bill the skilled nursing facility directly for this service rather than the payer, per consolidated billing rules, unless the service is on the exclusion list.
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 190 mean?
This charge is already covered by the per-diem payment for the patient's skilled nursing facility stay and isn't paid separately.
How do I resolve CARC 190?
Bill the skilled nursing facility directly for this service rather than the payer, per consolidated billing rules, unless the service is on the exclusion list.
Why does CARC 190 happen?
Skilled nursing facility consolidated billing rules bundle many ancillary services into the facility's per-diem rate.
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.