CARC 20
Belongs to a liability carrier
The payer considers another party's liability insurer responsible for this injury.
Why you actually get this
- The injury arose from an incident with a liable third party.
- The health plan is coordinating against a pending liability settlement.
How to check whether it’s correct
- 01Confirm whether a liability claim exists and who the carrier is.
- 02Establish whether the health plan will pay pending settlement.
Sometimes worth appealing
Some plans pay and then subrogate rather than refusing outright. Ask which position this payer takes before writing the claim off or sending it elsewhere.
Often arrives with
Seeing a lot of these?
A single denial is a claim to work. A pattern of the same denial is a process to fix, and the two need completely different responses. A free panel reads ninety days of your claims data and shows which codes actually recur for you.
Claim Adjustment Reason Codes are maintained by X12 as External Code List 139. The official description of this code is theirs and is not reproduced here. Check the authoritative list for current wording and status.