Claim adjustment reason code
Denial code CO-53 meaning
CARC 53, usually seen as CO-53: The plan does not pay for services by an immediate relative or a member of the patient's household.
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- Reason code
- CARC 53
- Short name
- Service by a relative not covered
- Plain meaning
- The plan does not pay for services by an immediate relative or a member of the patient's household.
- Group codes
- CO-53: 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 rendering provider is related to the patient.
What to check before resubmitting
- Confirm the relationship. If it is wrong, correct the claim and appeal.
Related reason codes
Related pages
Questions
What does denial code CO-53 mean?
The plan does not pay for services by an immediate relative or a member of the patient's household. This is Rivvi's plain-English summary of CARC 53. X12's exact wording is on x12.org.
How do I fix CO-53?
Confirm the relationship. If it is wrong, correct the claim and appeal.
Can I bill the patient for CO-53?
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 53?
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.