Appeal letter templates by denial code

Pick a denial code to get a ready-to-use appeal letter template, a checklist of what to attach, and guidance on when an appeal is worth it versus simply correcting and resubmitting the claim. Every template uses bracketed placeholders — replace them with your details before sending.

• CARC 11 — Diagnosis Inconsistent with Procedure appeal letter
• CARC 27 — Expenses Incurred After Coverage Terminated appeal letter
• CARC 29 — Timely Filing Limit Expired appeal letter
• CARC 31 — Patient Cannot Be Identified As Insured appeal letter
• CARC 40 — Not Qualified as Emergent/Urgent Care appeal letter
• CARC 50 — Not Medically Necessary appeal letter
• CARC 55 — Experimental/Investigational Procedure, Treatment, or Drug appeal letter
• CARC 58 — Inappropriate or Invalid Place of Service appeal letter
• CARC 95 — Plan Procedures Not Followed appeal letter
• CARC 96 — Non-Covered Charge(s) appeal letter
• CARC 97 — Benefit Included in Payment for Another Service (Bundling Denial) appeal letter
• CARC 107 — Related or Qualifying Claim/Service Not Identified appeal letter
• CARC 119 — Benefit Maximum Reached appeal letter
• CARC 150 — Information Submitted Does Not Support Level of Service appeal letter
• CARC 151 — Information Does Not Support Service Frequency/Quantity appeal letter
• CARC 152 — Length of Service Not Supported appeal letter
• CARC 167 — Diagnosis Not Covered appeal letter
• CARC 170 — Payment Denied Based on Provider Type appeal letter
• CARC 183 — Referring Provider Not Eligible to Refer appeal letter
• CARC 185 — Rendering Provider Not Eligible to Perform Service appeal letter
• CARC 197 — Missing Precertification/Authorization/Notification appeal letter
• CARC 198 — Precertification/Authorization Exceeded appeal letter
• CARC 204 — Service/Equipment/Drug Not Covered Under Plan appeal letter
• CARC 234 — Procedure Not Paid Separately (Bundled Service) appeal letter
• CARC 236 — Incompatible Procedure/Modifier Combination appeal letter
• CARC 288 — Referral Absent appeal letter

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Informational templates, not legal or billing advice. Verify your payer's appeal process and deadlines before submitting.