How do I resolve a CO-192 denial?

Review the plan's Summary of Benefits to confirm the service is excluded Inform the patient in writing that the service is not covered under their plan See full resolution steps at tryarceum.com.

Can I appeal a CO-192 denial?

CO-192 denials are generally not appealable. This is an informational code used for data translation between payers in coordination of benefits, not an actual payment denial or reduction that can be appealed.

CARC Code

192

🔴 Hard Denial

Non-Standard Paper Remittance Adjustment Code

This code is used when transferring payment information between insurance companies and the adjustment reason from a paper explanation of benefits cannot be translated into a standard electronic code. It applies specifically to coordination of benefits scenarios when deductible, coinsurance, or copayment information doesn't fit existing standard codes.

contractual

Resolution: 35%Hard difficulty21-45 days avg

How to resolve this denial

Which payer denied this claim?

Inform patient these services are not covered; bill patient directly

1
Review the plan's Summary of Benefits to confirm the service is excluded
2
Inform the patient in writing that the service is not covered under their plan
3
Determine if an ABN was issued prior to service (required for Medicare)
4
Bill the patient for the non-covered service if an ABN was signed
5
Document the non-coverage determination in the patient account

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▶✓ 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-192 — 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 192 by specialty.

Blue Cross Blue Shield

BCBS requires appeal submission within 180 days for most plans.

Appeal Letter Template

Generic appeal template for CARC 192 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 192 indicating: "Non-covered personal comfort or convenience services.." 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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