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Dentovio public answer
On a dental remittance, CARC 45 means: The controlling price limit is below the submitted charge, so the payer removed the excess.
On a dental remittance, CARC 45 means: The controlling price limit is below the submitted charge, so the payer removed the excess. That limit may come from a contract, fee schedule, statute, or plan allowance. X12 restricts its group code to PR or CO. No source read for this page pairs a specific remark code with it. Dentovio's appealability verdict — depends: check the facts first. The adjustment itself is contractual. What is contestable is the underlying fee schedule: if the allowed amount does not match your contracted schedule, request the fee schedule the claim was priced against and dispute the pricing — that is an underpayment dispute, not a benefits appeal.
Dentovio is an independent publisher — not a payer, the ADA, X12, CAQH CORE, or any government agency. Code meanings and remark-code meanings on this page are Dentovio's own wording, written from the official X12 Claim Adjustment Reason Code and Remittance Advice Remark Code lists and linked back to them; X12 holds the copyright in those lists and its descriptions are not reproduced here. CDT codes are referenced by number only; CDT is the American Dental Association's copyrighted code set and this page does not reproduce ADA descriptors. Appealability verdicts are Dentovio editorial classification, not a standard. Every fact traces to the code steward's registry, a federal rule or manual, a HIPAA operating rule, an association publication, or a named payer's own document — never to a billing blog. Educational billing reference only — not billing, legal, or clinical advice. Plan contracts control individual outcomes, and processing policies usually live in the payer's provider manual rather than in the signed agreement.
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