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Denial Code 5

CARC 5: The procedure code/type of bill is inconsistent with the place of service

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

2
Coinsurance Amount
3
Co-payment Amount
4
The procedure code is inconsistent with the modifier used
6
The procedure/revenue code is inconsistent with the patient's age
7
The procedure/revenue code is inconsistent with the patient's gender
8
The procedure code is inconsistent with the provider type/specialty

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