Dentovio public answer
CARC 46 denial code dental
On a dental remittance, CARC 46 means: A retired way of saying the plan does not cover the service.
Sourced answer
On a dental remittance, CARC 46 means: A retired way of saying the plan does not cover the service. X12 deactivated this code on 2003-10-16. X12's own note on the row directs users to code 96 instead. X12 assigns it no group code, so the group code on the remittance is the payer's choice under its own contract and it, not the CARC, decides who is assigned the balance. No source read for this page pairs a specific remark code with it. Dentovio's appealability verdict — structural: verify the plan terms. Treat the substance as a 96 non-covered decision and work it that way. If a payer is still sending 46 on a live remittance, that is worth raising with the payer separately — its own remittance is out of step with the code set it is required to use.
- Cluster
- Practice operations
- Last verified
- 2026-08-30
- Reviewer
- None — owner-published
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. This page was drafted with AI assistance and verified against the primary sources linked here. It has not been reviewed by a credentialed dental billing specialist, attorney, or clinician. 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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Source citations
- X12-CARC X12 Claim Adjustment Reason Codes (official list) (x12.org)
- ECFR-ERISA-CLAIMS 29 CFR 2560.503-1 — ERISA claims procedure (ecfr.gov)
- ECFR-MEDICAID-APPEALS 42 CFR 438.402 — Medicaid managed-care appeal framework (ecfr.gov)
- ECFR-MEDICAID-TIMING 42 CFR 438.408 — Medicaid managed-care appeal timing (ecfr.gov)