CARC Code

138

🔴 Hard Denial

Appeal procedures not followed or time limits not met.

Resolution: 35%Hard difficulty21-45 days avg

How to resolve this denial

Review appeal submission requirements and refile within allowed timeframe

  1. 1

    Pull submission logs from your clearinghouse or payer portal

  2. 2

    Gather all proof of timely filing: submission confirmation, rejection notices, prior payments

  3. 3

    Submit a formal appeal with timely filing evidence attached

  4. 4

    If proof is insufficient, review internal workflows to prevent future occurrences

  5. 5

    Document the appeal and set a follow-up reminder for 30 days

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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-138 — stats, related codes, appeal template

35%

Recovery Rate

21-45 days

Avg. Resolution

Hard

Difficulty

Occasional

Frequency

Payer-Specific Notes

How major payers handle CARC 138 by specialty.

Blue Cross Blue Shield

BCBS requires appeal submission within 180 days for most plans.

Appeal Letter Template

Generic appeal template for CARC 138 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 138 indicating: "Appeal procedures not followed or time limits not met.." 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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