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Denial Code 169

CARC 169: Alternate benefit has been provided

This is a Claim Adjustment Reason Code (CARC). CARCs explain why a payer adjusted or denied a claim line and appear with a group code (CO, PR, OA, PI). Codes appear on the EOB / ERA after a claim is adjudicated.

Reference only — CARC/RARC are national code sets updated periodically. Verify against the current official list before acting on a denial or appeal.

Related CARC codes

164
Attachment/other documentation referenced on the claim was not received in a timely fashio…
166
These services were submitted after this payers responsibility for processing claims under…
167
This diagnosis(es) is not covered
170
Payment is denied when performed/billed by this type of provider
171
Payment is denied when performed/billed by this type of provider in this type of facility
172
Payment is adjusted when performed/billed by a provider of this specialty

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