Payer deems the information submitted does not support this day's supply.
Group code
CO, PI or PR
Category
Medical Necessity
Risk level
High
Appealable
Yes
See the full resolution workflow for CARC 154
Members of the EDI-Code Intelligence Lab get the step-by-step rework path, appeal language, root-cause drivers, and prevention checklist for every CARC and RARC pairing, plus payer-specific quirks.
Open in EDI Lab