CARC49ReferenceCurrentVerified Aug 15, 2026CARC 49
AR Guide Workflow
Non-Covered Services
The service is not covered under the patient's benefit plan — an exclusion, a coverage limit, or a service the plan simply does not include.
AR Guide explanation
What it means
The service is not covered because it is a routine/preventive exam or a screening done with a routine/preventive exam.
AR Guide knowledge
Common denial category
Non-Covered Services — The service is not covered under the patient's benefit plan — an exclusion, a coverage limit, or a service the plan simply does not include.
AR Guide knowledge
Common causes
- Service classified as routine/preventive by the plan
- Preventive benefit limits exceeded
AR Guide knowledge
What AR should verify
- Review the plan's preventive/routine service coverage
- Confirm how the plan classifies the billed service
AR Guide knowledge
Recommended action
- Appeal if the service is medically necessary and not truly preventive
- Bill the patient per plan rules if the exclusion applies
About this guidance: Note
AR Guide knowledge is general reference content written by our team — it is not payer-specific policy and never replaces the payer’s documentation or your contract. Always confirm specifics with the payer.