CARC 276: Services denied by the prior payer(s) are not covered by this payer.
Services denied by the prior payer(s) are not covered by this payer.
CARC 276 appears on the 835 ERA (Electronic Remittance Advice) that the payer returns after claim adjudication. It explains a reduction, denial, or payment adjustment to your billing team. For your practice, the question is workflow: identify the pattern, route the denial to the right resolution path (rebill, appeal, write-off), and recover what's recoverable without burning RVU time on dead-end fights.
What CARC 276 means
The official X12 description is: “Services denied by the prior payer(s) are not covered by this payer.”
In plain language: Services denied by the prior payer(s) are not covered by this payer.
Practice workflow for CARC X 276
Appeal with documentation specific to this code. The provider's billing office can help clarify what the carrier wants.
ApprovalHelp auto-drafts the appeal letter against the right federal appeal-rights regulation (ACA §2719, ERISA §503, NSA §2799A, 42 CFR 422 Subpart M, or 42 CFR 438 Subpart F) for the patient's plan type, the payer's own coverage policy, and the relevant clinical guideline. Drafts route to the clinician for signature in under five minutes.
CARC 276 group codes explained
On the 835 ERA, CARC 276 appears alongside a group code that signals who is financially responsible for the adjustment. CO (Contractual Obligation) — Contractual write-off. The provider agreed to the rate. Patient does NOT owe this amount.
Frequently asked questions
What does CARC 276 mean?
Services denied by the prior payer(s) are not covered by this payer. In plain language: Services denied by the prior payer(s) are not covered by this payer.
Is CARC 276 appealable?
Yes — CARC 276 is one of the codes that commonly supports an appeal. Appeal with documentation specific to this code. The provider's billing office can help clarify what the carrier wants.
Which group code does CARC 276 appear under?
CARC 276 most often appears under: CO (Contractual Obligation) — Contractual write-off. The provider agreed to the rate. Patient does NOT owe this amount.
What's the practice workflow for a CARC 276 denial?
Appeal with documentation specific to this code. The provider's billing office can help clarify what the carrier wants.
Related resources
Sources
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