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CARC
CO-54
CARC
CO — Contractual Obligation
Non-Covered
Quick Facts
Code
CO-54
Type
CARC
Category
Non-Covered
Status
Active
Multiple physicians/assistants are not covered in this case
What Does This Code Mean?
The plan doesn’t cover having more than one physician or assistant involved for this type of case.
Common Causes
- Co-surgeon or assistant surgeon billed without payer-required documentation
- Multiple providers billed for overlapping roles
Recommended Next Steps
- Confirm whether the plan allows co-surgery/assistant billing with the right modifier
- Appeal with operative notes justifying multiple providers if applicable
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Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.