CARC 45 denial code: meaning & whether to appeal (verified)
What CARC 45 means
Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.
Verbatim description from the official X12 Claim Adjustment Reason Codes list.
Classification
Routing category: not denials
Appealability verdict
Contractual adjustment — not appealable as a denial
What to know
This is a contractual adjustment between billed charges and the contracted allowance. It is not a denial, and there is no appeal right attached to the adjustment itself.