Reference

Denial codes & appeal deadlines, verified.

Look up what a denial code means and whether it's worth appealing, and find the filing window that governs your claim. Every deadline is quoted from its primary source, and it is free to use.

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Denial codes (CARC)

Every trigger code Appealant works, grouped by denial type. Each page gives the verbatim X12 description, its classification, and a plain appealability verdict.

Eligibility

CARC 26 CARC 27 CARC 31 CARC 177

Timely filing

CARC 29

Prior authorization

CARC 15 CARC 39 CARC 197 CARC 198

Bundling / coding edits

CARC 59 CARC 97 CARC 231 CARC 234 CARC 236 CARC B15

Medical necessity

CARC 50 CARC 55 CARC 56 CARC 11 CARC 167

Coordination of benefits

CARC 22 CARC 23 CARC 109

Downcoding

CARC 150 CARC 151 CARC 186 CARC B16

Documentation requests

CARC 16 CARC 226 CARC 252

Duplicate claims

CARC 18

Contractual adjustments

CARC 45

Needs review

CARC 96

Verified deadline tables

Filing windows and payer response clocks, keyed on the regulator that governs each claim. The same payer can hold different windows on different products.

By regulatorCalifornia DMHCKnox-Keene HMOs — 365-day dispute floor By regulatorCalifornia CDIPPO & indemnity insurers By regulatorERISA self-fundedFederal employer-plan minimums By regulatorMedicare AdvantagePart C reconsideration clocks By regulatorMedi-Cal managed care42 CFR 438 + DHCS APL 21-011

By payer

UnitedHealthcareFiling & response windows → Anthem Blue Cross (CA)Filing & response windows → Blue Shield of CaliforniaFiling & response windows → Aetna (California)Filing & response windows → Cigna (California)Filing & response windows → Health Net (California)Filing & response windows → Molina Healthcare (CA)Filing & response windows →

Stop looking codes up one at a time.

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