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Denial Code 53

CARC 53: Services by an immediate relative or a member of the same household are not covered

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

49
This is a non-covered service because it is a routine/preventive exam or a diagnostic/scre…
50
These are non-covered services because this is not deemed a 'medical necessity' by the pay…
51
These are non-covered services because this is a pre-existing condition
54
Multiple physicians/assistants are not covered in this case
55
Procedure/treatment/drug is deemed experimental/investigational by the payer
56
Procedure/treatment has not been deemed 'proven to be effective' by the payer

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