CARC 33
Plan has no dependant coverage
The subscriber's plan covers the subscriber only, so no dependant claim can pay against it.
Why you actually get this
- The patient was billed under a family member's individual-only plan.
- Dependant coverage was dropped at renewal without the practice being told.
How to check whether it’s correct
- 01Confirm whether the plan is individual or family on the date of service.
- 02Ask the patient whether the dependant holds coverage elsewhere.
Rarely worth appealing
If the plan has no dependant coverage, there is nothing to overturn. The work is identifying the correct payer.
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.