CARC 27: Expenses incurred after coverage terminated.
The service was after your plan ended. Same logic as code 26 — not appealable on the merits without proof of continuation.
CARC 27 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 27 means
The official X12 description is: “Expenses incurred after coverage terminated.”
In plain language: The service was after your plan ended. Same logic as code 26 — not appealable on the merits without proof of continuation.
Common scenarios
- Job loss with gap before new coverage
- Aging off parent's plan
- Failed premium payment
What to do next 27
Confirm termination date in writing from the carrier. If you had COBRA or continuation, prove it. Otherwise, you owe.
CARC 27 group codes explained
On the 835 ERA, CARC 27 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 27 mean?
Expenses incurred after coverage terminated. In plain language: The service was after your plan ended. Same logic as code 26 — not appealable on the merits without proof of continuation.
Is CARC 27 appealable?
CARC 27 is usually not appealable on its own — it's typically a contractual, informational, or routine adjustment. Confirm termination date in writing from the carrier. If you had COBRA or continuation, prove it. Otherwise, you owe.
Which group code does CARC 27 appear under?
CARC 27 most often appears under: CO (Contractual Obligation) — Contractual write-off. The provider agreed to the rate. Patient does NOT owe this amount.
When does CARC 27 typically appear on a denial?
Common scenarios: Job loss with gap before new coverage; Aging off parent's plan; Failed premium payment.
What should I do if I see CARC 27 on the 835?
Confirm termination date in writing from the carrier. If you had COBRA or continuation, prove it. Otherwise, you owe.
Related resources
Sources
Contact: hello@denialhelp.com