CARC 15: The authorization number is missing, invalid, or does not apply to the billed services or provider.
The authorization number is missing, invalid, or does not apply to the billed services or provider.
CARC 15 is the code your insurance company used to explain why your claim was reduced, denied, or paid less than expected. It appears on your Explanation of Benefits (EOB) — the statement your plan sends after a claim is processed. Here's what it means for you and what you can do about it.
What CARC 15 means
The official X12 description is: “The authorization number is missing, invalid, or does not apply to the billed services or provider.”
In plain language: The authorization number is missing, invalid, or does not apply to the billed services or provider.
What to do next 15
Appeal with documentation specific to this code. The provider's billing office can help clarify what the carrier wants.
DenialHelp drafts the appeal letter for you in about five minutes. We cite the federal appeal-rights regulation that applies to your plan type (ACA §2719, ERISA §503, NSA §2799A, 42 CFR 422 Subpart M, or 42 CFR 438 Subpart F), the insurer's own coverage policy, and the relevant clinical guideline.
CARC 15 group codes explained
On the 835 ERA, CARC 15 appears alongside a group code that signals who is financially responsible for the adjustment. CO (Contractual Obligation) — Contractual write-off. The provider agreed to the rate. Patient does NOT owe this amount.
Frequently asked questions
What does CARC 15 mean?
The authorization number is missing, invalid, or does not apply to the billed services or provider. In plain language: The authorization number is missing, invalid, or does not apply to the billed services or provider.
Is CARC 15 appealable?
Yes — CARC 15 is one of the codes that commonly supports an appeal. Appeal with documentation specific to this code. The provider's billing office can help clarify what the carrier wants.
Which group code does CARC 15 appear under?
CARC 15 most often appears under: CO (Contractual Obligation) — Contractual write-off. The provider agreed to the rate. Patient does NOT owe this amount.
How do I appeal a CARC 15 denial?
Appeal with documentation specific to this code. The provider's billing office can help clarify what the carrier wants.
Related resources
Sources
Appeal a CARC 15 denial
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