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Denial Code 259

CARC 259: Additional payment for Dental/Vision service utilization

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

256
Service not payable per managed care contract
257
The disposition of the claim/service is undetermined during the premium payment grace peri…
258
Claim/service not covered when patient is in custody/incarcerated. Applicable federal, sta…
260
Processed under Medicaid ACA Enhanced Fee Schedule
261
The procedure or service is inconsistent with the patient's history
262
Adjustment for delivery cost

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