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CARC
CO-97
CARC
CO — Contractual Obligation
Coding/Modifier
Quick Facts
Code
CO-97
Type
CARC
Category
Coding/Modifier
Status
Active
Payment included in the allowance for another service already adjudicated
What Does This Code Mean?
The payer considers this service bundled into, or a component of, another procedure already paid on the same claim or date of service.
Common Causes
- Missing modifier 25 or 59 to indicate a separately identifiable service
- NCCI edit pair billed without an applicable modifier
- Global surgical package includes this service
Recommended Next Steps
- Check whether an NCCI-associated modifier applies and was omitted
- Confirm the service isn't genuinely part of a global package
- Resubmit with the correct modifier if separately identifiable
- Appeal with documentation if bundling was applied incorrectly
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Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.