CARC 39CO · Contractual Obligation
The service was already denied when prior authorization was requested, before the claim was even submitted.
- Common causes
- The payer determined during the pre-authorization review that the service wasn't covered or wasn't medically necessary.
- Suggested fix
- Review the original authorization denial reason; if appropriate, submit additional clinical documentation and appeal the authorization decision.
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 39 mean?
The service was already denied when prior authorization was requested, before the claim was even submitted.
How do I resolve CARC 39?
Review the original authorization denial reason; if appropriate, submit additional clinical documentation and appeal the authorization decision.
Why does CARC 39 happen?
The payer determined during the pre-authorization review that the service wasn't covered or wasn't medically necessary.
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.