CARC 3
Applied to the co-payment
Not a denial. A fixed patient charge for the visit type under their plan.
Why you actually get this
- Standard plan design.
- A co-payment not collected at the time of service now sitting in receivables.
How to check whether it’s correct
- 01Confirm the co-payment amount matches the plan.
- 02Check whether it was collected at the front desk — if not, it is now a collection task.
Rarely worth appealing
Nothing to appeal. Co-payments not collected at the desk cost far more to recover afterwards, which makes this a front-office process question rather than a billing one.
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.