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Denial Code 272

CARC 272: Coverage/program guidelines were not met

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

269
Anesthesia not covered for this service/procedure
270
Claim received by the medical plan, but benefits not available under this plan. Submit the…
271
Prior contractual reductions related to a current periodic payment as part of a contractua…
273
Coverage/program guidelines were exceeded
274
Fee/Service not payable per patient Care Coordination arrangement
275
Prior payer's patient responsibility not covered

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