How do I resolve a CO-39 denial?

Pull the original authorization request and approval (if any) Determine whether a retroactive authorization request is an option with this payer See full resolution steps at tryarceum.com.

Can I appeal a CO-39 denial?

Yes. Most CO-39 denials can be appealed within 60-180 days depending on payer. Authorization denials are typically appealable if additional clinical documentation or medical justification can demonstrate the service meets medical necessity and coverage criteria. Use our free tool to generate an appeal letter.

CARC Code

39

🔴 Hard Denial

Authorization Denied When Requested

The insurance company reviewed the request for prior authorization or pre-certification and denied it before the service was provided. This means the payer determined the service was not medically necessary or did not meet coverage criteria at the time approval was sought.

authorization

Resolution: 35%Hard difficulty21-45 days avg

How to resolve this denial

Which payer denied this claim?

Review denial reasons and submit appeal with clinical documentation

1
Pull the original authorization request and approval (if any)
2
Determine whether a retroactive authorization request is an option with this payer
3
Prepare clinical documentation supporting medical necessity for the service
4
Submit the retroactive authorization request through the payer portal
5
Submit a formal appeal once the authorization is obtained or denied
6
Document all communication with the payer in the patient account

Resolve this denial →

▶✓ 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-39 — 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 39 by specialty.

Blue Cross Blue Shield

BCBS requires appeal submission within 180 days for most plans.

Common 835 Combinations

CARC 39 most often appears with these Group Code + RARC combinations on 835 remittances.

COCO-39This denial indicates the payer declined to authorize or pre-certify servicesAppealable

Look up any combination →

Appeal Letter Template

Generic appeal template for CARC 39 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 39 indicating: "Services denied at the time authorization/pre-certification was requested.." 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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