CARC 258CO · Contractual Obligation
The service isn't covered because the patient was incarcerated at the time, which affects insurance coverage under most plans.
- Common causes
- Most health plans, including Medicare and Medicaid, exclude coverage while a patient is in the custody of a penal authority, with correctional facilities typically responsible instead.
- Suggested fix
- Bill the correctional facility or applicable public program responsible for inmate healthcare rather than the standard payer.
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 258 mean?
The service isn't covered because the patient was incarcerated at the time, which affects insurance coverage under most plans.
How do I resolve CARC 258?
Bill the correctional facility or applicable public program responsible for inmate healthcare rather than the standard payer.
Why does CARC 258 happen?
Most health plans, including Medicare and Medicaid, exclude coverage while a patient is in the custody of a penal authority, with correctional facilities typically responsible instead.
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.