Claim adjustment reason code · X12
CO-174: service not prescribed prior to delivery.
CARC 174 says the service was not prescribed prior to delivery. The payer looked for an order or prescription that predates the date the service or item was delivered and did not find one. Check the order date against the delivery date.
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What X12 says CARC 174 means
Service was not prescribed prior to delivery.
CARC 174 · Start 06/30/2005, last modified 09/30/2007.
In plain terms: The payer found no order or prescription that predates delivery of the service or item.
What it means on a remittance
The code is about timing of the order. The X12 text does not say which services need an order; that is set by each payer's policy.
Typical causes
- No order or prescription is on file for the service.
- The order is dated after the date of delivery.
- The order exists but was not sent to the payer or is missing required elements.
- The date of service on the claim is earlier than the true order date.
These are common billing patterns, not a diagnosis of your claim. The remittance and the payer's policy decide.
What to check
- Compare the order date with the delivery date on the claim.
- Confirm the order is signed by an authorized prescriber and filed in the record.
- Check the payer policy for what an order must contain and when it is due.
- Check the remark code on the line for further direction.
Correct, resubmit or appeal
If the order existed before delivery and the claim was missing it, submit a corrected claim or send the order as the payer requires. If the order really postdates delivery, the denial may stand, and the payer contract decides who bears the cost. For Medicare, a redetermination is filed within 120 days of receiving the notice.
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: Related: CARC 55 and the full lookup.
Worked example (hypothetical)
A supplier delivers an item on a Tuesday and receives a signed order dated the following Friday. The claim returns CO-174. The supplier checks the record, finds the order postdates delivery, and treats the denial as correct under its payer contract.
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.
Frequently asked questions
Does CO-174 mean the prescriber made an error?
Not necessarily. It means the payer could not find an order dated before delivery.
Can I bill the patient after CO-174?
CO is generally written off by the provider, so generally not billable to the patient. Your contract controls.
Which services need an order?
X12 does not say. The payer's policy for the service does, so read it.
Not legal, billing or medical advice
This page explains published code lists and rules and runs a lookup in your browser. It cannot see your claim, your contract or any payer's policy. Confirm with the payer or your Medicare Administrative Contractor before you resubmit, appeal or bill a patient.