CARCContractual Obligation
CARC 133: The disposition of this claim/service is pending further review
Your insurer hasn't made a final decision yet — the claim is still under review.
What this means for your claim
This is a holding code while the insurer completes review (e.g., medical necessity review, coordination of benefits, or fraud investigation). A final EOB should follow.
What to do next
- 1
Note the date you received this EOB and follow up with your insurer if no final determination arrives within 30 days.
- 2
Ask the insurer for the expected resolution timeline and the reason for the pending status.
- 3
Do not pay the provider's bill until the final EOB is issued.
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