PostAcuteTools
Claims · Remittance

CARC / RARC / CAGC Lookup

Enter an adjustment group code, a CARC, and/or a RARC and get plain-English posting guidance — what it suggests, whether it can be billed to the patient, a suggested payment-posting bucket and GL bucket, and a follow-up action. The group code drives the financial treatment; the CARC explains why; the RARC adds detail.

Reference OnlyPartial datasetBrowser-onlyNo PHI
No PHI

Do not paste patient names, Medicare IDs, SSNs, full claim files containing PHI, or other protected health information. This tool is intended for de-identified examples and educational / reconciliation support. Everything runs in your browser — nothing you paste is stored, logged, or sent anywhere. This tool only needs codes and an optional amount — no patient identifiers are required.

Data statusReference Only
Status
Reference Only
Data year / effective
X12 external code lists (CARC / RARC / CAGC)
Last reviewed
May 2026
Last updated
May 2026
Primary source
ASC X12 Claim Adjustment Reason / Remittance Advice Remark / Group codes
Formula notes
The group code (CAGC) drives the financial treatment and patient-billing rule; the CARC explains the reason; the RARC adds supplemental detail. Posting and GL buckets are suggestions, not a coverage or appeal determination.
Known exclusions
  • Curated post-acute seed set — NOT the complete official code library
  • Official CARC/RARC text is copyrighted by X12 and revised three times a year
  • Patient-billing outcomes also depend on ABN / advance-notice rules
  • Payer contracts and state Medicaid rules override these defaults
Browser-onlyNo PHI

Reference guidance only. Verify the exact code wording and the latest list at x12.org, and confirm write-off / posting decisions against your organization's policy.

Codes & context

      Posting guidance

      Pick a group code and enter a CARC or RARC, then choose Look up.

      Code library

      Curated post-acute seed set — meanings are paraphrased for posting guidance, not the official X12 text.

      This tool gives posting guidance, not a coverage or appeal determination. Code meanings are short paraphrases of a curated, frequently-seen post-acute subset — not the complete official set, which is maintained and updated three times a year by X12 (via the Washington Publishing Company). Patient-billing outcomes also depend on ABN / advance-notice rules and the payer contract. Verify the exact code wording and the latest list at x12.org, and confirm posting and write-off decisions against your organization's policy.

      Related

      835 / ERA Decoder Revenue Codes Type of Bill Decoder Condition / Occurrence / Value Guide: How a Medicare Claim Is Built

      Group codes (CAGC), CARC, and RARC are ASC X12 external code lists. Group-code financial treatment and the posting/GL suggestions here are paraphrased references — the authoritative, current code lists live at x12.org/codes.