Adjusted for failure to obtain second surgical opinion.
Group code
CO, PI or PR
Category
Plan Provision
Risk level
Medium
Appealable
Review Required
See the full resolution workflow for CARC 61
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.
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