Claim adjustment reason code
Denial code CO-213 meaning
CARC 213, usually seen as CO-213: The service conflicts with the physician self-referral (Stark) law or payer policy.
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- Reason code
- CARC 213
- Short name
- Self-referral rule
- Plain meaning
- The service conflicts with the physician self-referral (Stark) law or payer policy.
- Group codes
- CO-213: Contractual obligation. The provider absorbs the amount under its contract or the payer's rules. Do not bill the patient for it.
Plain-English summary written by Rivvi. X12 owns the CARC list and its exact wording, which is not reproduced here. Read it on the X12 CARC list (list dated November 1, 2025, checked October 23, 2026). This page does not decide how a claim is paid.
Common causes
- The referring physician has a financial relationship with the entity billing the service.
What to check before resubmitting
- Review the referral relationship with compliance counsel.
Related pages
Questions
What does denial code CO-213 mean?
The service conflicts with the physician self-referral (Stark) law or payer policy. This is Rivvi's plain-English summary of CARC 213. X12's exact wording is on x12.org.
How do I fix CO-213?
Review the referral relationship with compliance counsel.
Can I bill the patient for CO-213?
With group code CO, no. CO means the provider absorbs the amount under its contract or the payer's rules.
Which group codes come with CARC 213?
Most often CO (contractual obligation). The group code, not the reason code, says who owes the amount.
What is the difference between a CARC and a RARC?
A claim adjustment reason code (CARC) says why a claim line was paid differently than billed. A remittance advice remark code (RARC) adds detail, such as which field is missing.