CARC 5CO · Contractual Obligation
The procedure billed isn't valid for the place of service reported on the claim.
- Common causes
- Certain procedures can only be billed from specific settings, and this one was billed from a setting the payer doesn't recognize as appropriate for it.
- Suggested fix
- Confirm the correct place-of-service code for where the service was actually rendered 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 5 mean?
The procedure billed isn't valid for the place of service reported on the claim.
How do I resolve CARC 5?
Confirm the correct place-of-service code for where the service was actually rendered and resubmit.
Why does CARC 5 happen?
Certain procedures can only be billed from specific settings, and this one was billed from a setting the payer doesn't recognize as appropriate for it.
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.