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CARC
CO-45
CARC
CO — Contractual Obligation
Non-Covered
Quick Facts
Code
CO-45
Type
CARC
Category
Non-Covered
Status
Active
Charge exceeds fee schedule/maximum allowable or contracted amount
What Does This Code Mean?
The billed amount is more than the contracted or fee-schedule allowed amount; the difference is a contractual write-off, not something that can be billed to the patient.
Common Causes
- Charges billed at standard rate rather than contracted rate
- Fee schedule update not reflected in practice management system
- Out-of-date contract terms loaded in billing software
Recommended Next Steps
- Confirm this is a standard contractual adjustment, not a payment error
- Write off the adjustment amount per the contract — do not bill the patient
- Periodically reconcile your fee schedule against current payer contracts
- Escalate to payer contracting if the allowed amount looks incorrect
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Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.