CARC 97 — This service is considered part of (bundled into) another procedure already paid

CARC 97CO · Contractual Obligation

This service is considered part of (bundled into) another procedure already paid on this or a related claim, so it isn't paid separately.

Common causes: National Correct Coding Initiative edits or payer bundling rules consider this service inclusive of a related, already-reimbursed procedure.
Suggested fix: Verify whether an appropriate modifier (such as 59 or an X-modifier) applies to indicate a distinct service; if so, resubmit with the modifier and supporting documentation.

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 97 mean?

This service is considered part of (bundled into) another procedure already paid on this or a related claim, so it isn't paid separately.

How do I resolve CARC 97?

Verify whether an appropriate modifier (such as 59 or an X-modifier) applies to indicate a distinct service; if so, resubmit with the modifier and supporting documentation.

Why does CARC 97 happen?

National Correct Coding Initiative edits or payer bundling rules consider this service inclusive of a related, already-reimbursed procedure.

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.