Patient has not met the required spend down requirements.
Group code
CO, PI or PR
Category
Patient Eligibility
Risk level
High
Appealable
Review Required
See the full resolution workflow for CARC 178
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