CARC Code
180
Residency Requirements Not Met
The claim was denied because the patient does not meet the payer's residency requirements for coverage. This typically means the patient lives outside the plan's service area or has not established residency in the required location.
eligibilityHow to resolve this denial
Review Medicare bundling rules; rebill as part of the bundled payment if applicable
- 1
Review NCCI edits for the billed procedure combination
- 2
Determine if a modifier is applicable to bypass the bundling edit (e.g., -59, XE, XS, XP, XU)
- 3
Verify the procedures were performed independently and at separate sites/times
- 4
If modifier is appropriate, resubmit with the correct modifier and documentation
- 5
If bundled correctly, accept the reduction and adjust the claim balance
▶✓ 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-180 — 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 180 by specialty.
Blue Cross Blue Shield
BCBS requires appeal submission within 180 days for most plans.
Appeal Letter Template
Generic appeal template for CARC 180 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 180 indicating: "Claim/Service denied — Medicare service not billable separately.." 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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