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Frequency / medical necessity appealable with recordsDenial Code CARC 151: Payer deems the information submitted doesn't support this many/frequency of services
CARC 151 means: payer deems the information submitted doesn't support this many/frequency of services. Here's what it means in plain English, why it happens, and how it's worked toward payment.
CARC 151 — Payer deems the information submitted doesn't support this many/frequency of services. Denial family:
Frequency / medical necessity.
Why you get a CARC 151 denial
- The number or frequency of services billed exceeds what the payer's policy expects.
- Documentation supporting the frequency wasn't submitted.
- Units were coded incorrectly.
How to fix or appeal CARC 151
- Verify the units/frequency are coded correctly.
- If clinically justified, appeal with documentation supporting the frequency.
- Cross-walk to the payer's policy on service limits.
Recoverable when the frequency is clinically supported and you submit the records to prove it.
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CARC 151 — FAQ
What does CARC 151 mean?
The payer thinks too many services/units were billed for the period. If the frequency is clinically necessary and documented, it's appealable with records.
How do I appeal CARC 151?
Submit the documentation that justifies the frequency and cross-walk it to the payer's service-limit policy; confirm units were coded correctly first.