CARC 269 — Anesthesia services for this particular procedure aren't covered under the plan

CARC 269PR · Patient Responsibility

Anesthesia services for this particular procedure aren't covered under the plan.

Common causes: The plan doesn't cover anesthesia for this specific procedure type, such as certain elective or cosmetic-adjacent procedures.
Suggested fix: Confirm the plan's anesthesia coverage policy for this procedure; if excluded, the patient is responsible after being informed of the exclusion.

Related Patient Responsibility codes

1The billed amount was applied to the patient's plan deductible instead of being paid by the payer.119The patient has used up the maximum benefit allowed for this service within the applicable time period, such as an annual visit limit.167The specific diagnosis code(s) on this claim aren't covered under the patient's plan.177The patient doesn't currently meet the plan's eligibility criteria for this benefit.187This amount was or should be paid from the patient's consumer-directed spending account, such as an HSA or FSA, rather than by the payer.2This portion of the claim represents the patient's coinsurance share, the percentage of the allowed amount they are responsible for under their plan.200The service date falls within a period when the patient's coverage had lapsed.201The patient is responsible for this amount under a legal set-aside arrangement, commonly seen in workers' compensation Medicare Set-Aside cases, rather than the payer.

Frequently asked questions

What does CARC 269 mean?

Anesthesia services for this particular procedure aren't covered under the plan.

How do I resolve CARC 269?

Confirm the plan's anesthesia coverage policy for this procedure; if excluded, the patient is responsible after being informed of the exclusion.

Why does CARC 269 happen?

The plan doesn't cover anesthesia for this specific procedure type, such as certain elective or cosmetic-adjacent procedures.

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.