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Denial Code 178

CARC 178: Patient has not met the required spend down requirements

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

175
Prescription is incomplete
176
Prescription is not current
177
Patient has not met the required eligibility requirements
179
Patient has not met the required waiting requirements
180
Patient has not met the required residency requirements
181
Procedure code was invalid on the date of service

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