CARC 7: The procedure code is inconsistent with the place of service
The billed procedure doesn't match the type of facility or location where the service was performed.
What this means for your claim
Certain procedures are expected to be performed only in specific settings (e.g., inpatient hospital vs. outpatient clinic). A mismatch triggers an adjustment.
What to do next
- 1
Ask the provider to verify the place of service code matches where the procedure was actually performed.
- 2
If the service was performed at an outpatient facility but billed as inpatient, a resubmission with the corrected code may resolve the issue.
- 3
Request the provider's appeal on your behalf if the place of service coding was an administrative error.
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