CARC Code

113

🔴 Hard Denial

Payment denied because service/procedure was provided outside the United States or as a result of war.

Resolution: 35%Hard difficulty21-45 days avg

How to resolve this denial

Review plan exclusions for overseas services; limited appeal options

  1. 1

    Review the plan's Summary of Benefits to confirm the service is excluded

  2. 2

    Inform the patient in writing that the service is not covered under their plan

  3. 3

    Determine if an ABN was issued prior to service (required for Medicare)

  4. 4

    Bill the patient for the non-covered service if an ABN was signed

  5. 5

    Document the non-coverage determination in the patient account

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✓ Pre-action checklist — verify before contacting the payer
  1. Review the full remittance advice (ERA/EOB) for additional RARC codes that explain the denial.

  2. Verify the claim was submitted with correct patient eligibility and benefit information.

  3. Check if this denial applies to a specific line item or the entire claim.

More about CO-113 — stats, related codes, appeal template

35%

Recovery Rate

21-45 days

Avg. Resolution

Hard

Difficulty

Rare

Frequency

Payer-Specific Notes

How major payers handle CARC 113 by specialty.

Blue Cross Blue Shield

BCBS requires appeal submission within 180 days for most plans.

Appeal Letter Template

Generic appeal template for CARC 113 denials.

We are submitting a formal appeal for claim [CLAIM_NUMBER] for patient [PATIENT_NAME], date of service [DOS]. This claim was denied/adjusted with CARC 113 indicating: "Payment denied — service/procedure provided outside the United States or due to ." We have reviewed the claim and are providing the attached documentation to support reconsideration. [SUPPORTING_DOCUMENTATION]. Please reconsider payment per the terms of our contract.

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