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Denial Code 280

CARC 280: Claim received by the medical plan, but benefits not available under this plan. Submit these services to the patient's Pharmacy plan for further consideration

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

277
The disposition of the claim/service is undetermined during the premium payment grace peri…
278
Performance program proficiency requirements not met
279
Services not provided by Preferred network providers
281
Deductible waived per contractual agreement. Use only with Group Code CO
282
The procedure/revenue code is inconsistent with the type of bill
283
Attending provider is not eligible to provide direction of care

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