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Denial Code P18

CARC P18: Procedure is not listed in the jurisdiction fee schedule. An allowance has been made for a comparable service. To be used for Property and Casualty only

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

P15
Workers' Compensation Medical Treatment Guideline Adjustment. To be used for Workers' Comp…
P16
Medical provider not authorized/certified to provide treatment to injured workers in this …
P17
Referral not authorized by attending physician per regulatory requirement. To be used for …
P19
Procedure has a relative value of zero in the jurisdiction fee schedule, therefore no paym…
P20
Service not paid under jurisdiction allowed outpatient facility fee schedule. To be used f…
P21
Payment denied based on the Medical Payments Coverage and/or Personal Injury Protection Be…

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