CARC Code
153
Dosage Not Supported by Documentation
The insurance company reviewed your claim and determined that the medical records or documentation you submitted do not justify the amount or frequency of medication that was prescribed and billed.
medical necessityHow to resolve this denial
Submit appeal with clinical documentation supporting day's supply
- 1
Obtain the complete medical record documenting the clinical need for the service
- 2
Review the payer's LCD/NCD or coverage policy for the billed procedure
- 3
Prepare a Letter of Medical Necessity from the treating physician
- 4
Submit a formal appeal with clinical records, the letter, and peer-reviewed literature
- 5
Track the appeal and follow up within 30 days
▶✓ Pre-action checklist — verify before contacting the payer
Review the full remittance advice (ERA/EOB) for additional RARC codes that explain the denial.
Verify the claim was submitted with correct patient eligibility and benefit information.
Check if this denial applies to a specific line item or the entire claim.
▶More about CO-153 — 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 153 by specialty.
Blue Cross Blue Shield
BCBS requires appeal submission within 180 days for most plans.
Appeal Letter Template
Generic appeal template for CARC 153 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 153 indicating: "Payer deems info does not support this day's supply.." 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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