CO-152: Information Does Not Support Length of Service

What Does CO-152 Mean?

With CO (Contractual Obligation), the CARC 152 denial for information does not support length of service is the provider's contractual responsibility. The patient is not liable for this amount. However, the provider may appeal with supporting clinical or administrative documentation if the denial is believed to be in error.

CARC 152 indicates information does not support length of service. The payer determined that the service or a portion of it does not meet coverage criteria under the patient's current plan benefits or the applicable coverage rules.

Common scenarios that trigger this adjustment include: the payer determines the length of the inpatient stay exceeds what is medically necessary based on the diagnosis and clinical documentation, and reduces payment to cover only the approved number of days; The clinical documentation does not adequately support the duration of the treatment or service, such as prolonged therapy sessions or extended observation periods; The billed service duration exceeds the payer's established time limits for that procedure or service category. The group code paired with CARC 152 determines who bears the financial responsibility — CO places it on the provider as a contractual obligation, PR shifts it to the patient, OA indicates a coordination of benefits or other payer adjustment.

Common Causes

How to Resolve

1. Review the denial Examine the CO-152 denial and any RARC codes to understand the specific basis for the coverage determination.
2. Gather supporting documentation Collect medical records, clinical notes, authorization documents, or other evidence that supports the medical necessity or coverage of the denied service.
3. File the appeal Appeal with detailed clinical documentation supporting the medical necessity for the full length of service, including daily progress notes, clinical assessments, evidence of clinical instability or deterioration that prevented earlier discharge, and the discharge planning timeline.
4. Track the appeal outcome Monitor the appeal status and follow up as needed. If denied again, consider further levels of appeal if available.

Common RARC Pairings

The RARC code tells you exactly what triggered the CO-152:

How to Prevent CO-152

• Conduct concurrent utilization reviews during inpatient stays to ensure ongoing medical necessity documentation
• Obtain continued stay authorizations from payers before the approved length of stay expires
• Document clinical justification for each day of extended service in the medical record
• Implement discharge planning early to ensure timely transitions to lower levels of care
• Monitor payer-specific length-of-stay guidelines and communicate them to clinical teams
• Use case management to track authorization status and initiate extensions before deadlines

Also Filed As

The same CARC 152 may appear with different Group Codes:

Related Denial Codes