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Denial Code 61

CARC 61: Adjusted for failure to obtain second surgical opinion

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

58
Treatment was deemed by the payer to have been rendered in an inappropriate or invalid pla…
59
Processed based on multiple or concurrent procedure rules
60
Charges for outpatient services are not covered when performed within a period of time pri…
66
Blood Deductible
69
Day outlier amount
70
Cost outlier - Adjustment to compensate for additional costs

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