CARC 182 Active

CO-182: Procedure Modifier Invalid on Date of Service

TL;DR

Correct the modifier to one that was valid on the date of service and resubmit. Do not appeal.

Action
Verify & Resubmit
Who Pays
Provider
Appeal
No
Patient Impact
None
Disclaimer
This content is for informational purposes only and does not constitute professional billing advice. Always verify information against your payer contracts and current coding guidelines. Consult a certified billing specialist for specific claim issues.

What Does CO-182 Mean?

With CO (Contractual Obligation), the invalid modifier is the provider's responsibility to correct. Identify the proper replacement modifier and resubmit the claim. This is a straightforward coding correction that does not require an appeal.

CARC 182 indicates that a modifier appended to a procedure code on the claim was either expired, not yet effective, or otherwise invalid for the date of service. Modifiers provide additional information about how or where a service was performed, and like procedure codes, they have defined validity periods.

This denial commonly occurs after annual coding updates when modifiers are retired or replaced, when billing systems are not updated with current modifier tables, or when an incorrect modifier is applied due to a data entry error. The resolution is to identify the correct modifier and resubmit the claim.

Common Causes

Cause Frequency
Modifier expired or retired before date of service The procedure modifier used on the claim was retired or no longer valid before the date the service was rendered Most Common
Incorrect modifier used for the procedure The modifier appended to the procedure code is not valid for that specific code or does not apply to the circumstances of the service Most Common
Modifier not yet effective on date of service The modifier has a future effective date and was not valid on the date the service was performed Common
Typographical error in modifier A data entry error resulted in an invalid modifier being submitted on the claim Common
Billing system not updated with modifier changes The provider's billing system was not updated with the latest modifier changes, resulting in use of outdated modifiers Common

How to Resolve

  1. Check the modifier's validity dates Verify the modifier's effective and termination dates against the date of service.
  2. Identify the correct modifier Determine the appropriate modifier based on the service circumstances and current coding guidelines.
  3. Resubmit with the correct modifier Update the claim and resubmit.
  4. Update modifier tables Ensure your billing system has current modifier tables to prevent future denials.
Do Not Appeal This Code

This denial indicates the modifier was not valid on the date of service. Correct the modifier and resubmit the claim rather than appealing.

Common RARC Pairings

The RARC code tells you exactly what triggered the CO-182:

RARC Description
M20 Missing/incomplete/invalid HCPCS modifier Verify the modifier is valid for the procedure code and date of service, then resubmit →
N130 You may need to review plan documents or guidelines Review current modifier listings for valid replacements →

How to Prevent CO-182

Also Filed As

The same CARC 182 may appear with different Group Codes:

Related Denial Codes

Sources

  1. https://www.mdclarity.com/denial-code/182
  2. https://x12.org/codes/claim-adjustment-reason-codes
  3. https://portal.ct.gov/-/media/ohs/health-it-advisory-council/apcd-advisory-group/data-submission-guide-workgroup/meeting-materials/6-30-22/carc-codes_final.pdf
  4. https://medicaid-documents.dhhs.utah.gov/Documents/pdfs/ClaimDenialCodes.pdf
  5. Codes maintained by X12. Visit x12.org for official definitions.