CARC 224CO · Contractual Obligation
The patient's identity information may have been compromised by identity theft, affecting claim processing.
- Common causes
- The payer flagged suspected fraudulent use of the patient's identity or insurance information.
- Suggested fix
- Verify the patient's identity through appropriate channels and work with the payer's fraud unit to resolve and resubmit.
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 224 mean?
The patient's identity information may have been compromised by identity theft, affecting claim processing.
How do I resolve CARC 224?
Verify the patient's identity through appropriate channels and work with the payer's fraud unit to resolve and resubmit.
Why does CARC 224 happen?
The payer flagged suspected fraudulent use of the patient's identity or insurance information.
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.