CARC Code

199

🟡 Soft Denial

Revenue and Procedure Code Mismatch

The revenue code (which identifies the type of service or department) does not align with the procedure code (which describes the specific service performed). The payer's system requires these two codes to be compatible with each other.

coding
Resolution: 82%Medium difficulty7-14 days avg

How to resolve this denial

Correct revenue code to match procedure code; resubmit UB-04

  1. 1

    Pull the original claim and review the specific field flagged by the RARC code

  2. 2

    Compare claim data against the patient's insurance card and eligibility response

  3. 3

    Correct the identified field(s) in the practice management system

  4. 4

    Resubmit the corrected claim via the payer portal or clearinghouse

  5. 5

    Confirm receipt and track the corrected claim to adjudication

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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-199 — stats, related codes, appeal template

82%

Recovery Rate

7-14 days

Avg. Resolution

Medium

Difficulty

Occasional

Frequency

Payer-Specific Notes

How major payers handle CARC 199 by specialty.

UnitedHealthcare

Review UHC's online claim status tool for additional detail on this adjustment.

Appeal Letter Template

Generic appeal template for CARC 199 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 199 indicating: "Revenue code and Procedure code do not match.." 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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