CO-112: service not furnished directly to the patient or not documented.

What X12 says CARC 112 means

Service not furnished directly to the patient and/or not documented.

CARC 112 · Start 01/01/1995, last modified 09/30/2007.

In plain terms: The payer says the service was not furnished directly to the patient, or the record does not document it.

What it means on a remittance

The X12 text has two parts joined by "and/or": the service was not furnished directly to the patient, or it was not documented. X12 does not say which part the payer applied, so the remark code and the payer's notice are where the specific reason sits.

Typical causes

• The service was furnished to someone other than the patient, or by an arrangement the payer does not treat as direct service.
• The record the payer reviewed does not show the service or does not support the dates, units or provider billed.
• The place of service or rendering provider on the claim does not match where and by whom the service was done.
• A claim-entry error put the service on the wrong patient or the wrong date.

These are common billing patterns, not a diagnosis of your claim. The remittance and the payer's policy decide.

What to check

1. Pull the record for the date of service and confirm the service, the rendering provider and the patient are all documented.
2. Compare the claim line (rendering provider, place of service, dates, units) with the record. The NPI lookup confirms the provider number.
3. Read the remark code and any policy reference on the same line.
4. Check whether the payer asked for records or sent a records-request letter before the denial.

Correct, resubmit or appeal

If the claim data was wrong, submit a corrected claim as the payer requires. If the service was furnished and documented, ask for review and attach the record that shows it. For Medicare that is a redetermination within 120 days of receiving the notice. If the service was not furnished as billed, the denial may be correct and the claim should not be resubmitted unchanged.

Medicare dates that apply

A Medicare redetermination request must be filed within 120 calendar days from the date a party receives the notice of the initial determination; receipt is presumed 5 calendar days after the notice date unless there is evidence to the contrary (42 CFR 405.942(a)), and a late request can be considered for good cause (405.942(b)). Other payers set their own appeal windows in the contract or plan documents, so read the notice for the date. The tool above runs the date math.

Related codes

Other codes: CARC 50 (medical necessity) and the full lookup.

Worked example (hypothetical)

A line comes back CO-112. The record for that visit has a signed note, but the claim names the supervising physician as rendering provider while a different clinician performed the service. The biller corrects the rendering provider, submits a corrected claim and notes the date. The record itself was never in question.

Sources

• X12: Claim Adjustment Reason Codes — code text, usage notes and dates (list dated 10/30/2026, retrieved 2026-11-02)
• 42 CFR 405.942 — eCFR, current through 2026-10-29 (retrieved 2026-11-02)

Code descriptions are X12 copyrighted material, quoted here only for the codes on this page and linked to the owner. For the full lists, use X12. The X12 text and the Medicare rule above were read from these pages on November 2, 2026. Causes, checks and examples are general billing practice written for this page, not X12 content. Payers revise code lists, contracts and policies, so confirm anything that affects a claim or a deadline with the payer.