CARC 55: Procedures or services are not compatible with this type of service
The billed procedure can't be performed or billed alongside another procedure that was already paid.
What this means for your claim
Certain procedure code combinations are considered clinically redundant or mutually exclusive. This is enforced through Correct Coding Initiative (CCI) edits.
What to do next
- 1
Ask your provider to check whether the procedures billed are subject to CCI bundling edits.
- 2
If the procedures were genuinely separate and distinct, a modifier may allow separate billing — ask the provider to review and resubmit if appropriate.
- 3
Request a clinical review if you believe the services were clearly separate procedures performed independently.
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