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CARC Code Reference

CARC P7: The applicable fee schedule/fee database does not contain the billed code. Please resubmit a bill with the appropriate fee schedule/fee database code(s) that best describe the service(s) provided and supporting documentation if required. To be used for Property and Casualty only.

The applicable fee schedule/fee database does not contain the billed code. Please resubmit a bill with the appropriate fee schedule/fee database code(s) that best describe the service(s) provided and supporting documentation if required. To be used for Property and Casualty only.

Group code CO or PI
Category P&C Guidelines
Risk level Medium
Appealable Review Required

Common RARC pairings

RARCs (Remittance Advice Remark Codes) provide the specific reason detail alongside CARC P7 on the 835 electronic remittance. These are the RARCs seen most often with this CARC.

RARCMeaning
M51 Missing/incomplete/invalid procedure code(s).
M119 Missing/incomplete/invalid/ deactivated/withdrawn National Drug Code (NDC).

See the full resolution workflow for CARC P7

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