CARC Code
154
Days Supply Not Supported
The payer has determined that the documentation you submitted does not justify the number of days' supply billed for the medication or supplies. They need additional evidence to support the quantity dispensed.
medical necessityHow to resolve this denial
Submit appeal with clinical documentation supporting treatment duration
- 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-154 — 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 154 by specialty.
Blue Cross Blue Shield
BCBS requires appeal submission within 180 days for most plans.
Appeal Letter Template
Generic appeal template for CARC 154 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 154 indicating: "Length of service not appropriate.." 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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