What does the denial code CO mean?

What does the denial code CO mean?

Contractual Obligation
What does the denial code CO mean? CO Meaning: Contractual Obligation (provider is financially liable).

What does CO 45 mean on an EOB?

CO-45: Charges exceed fee schedule/maximum allowable or contracted/legislated fee arrangement. Use Group Codes PR or CO, depending on the liability. Write off the indicated amount. CO-50: Non-covered services that are not deemed a “medical necessity” by the payer.

What is the reason code for deductible?

Reason Code 63: Blood Deductible. Reason Code 66: Day outlier amount. Reason Code 67: Cost outlier – Adjustment to compensate for additional costs. Reason Code 68: Primary Payer amount.

What does denial code MA63 mean?

MA63– Missing/incomplete/invalid principal diagnosis means that the first listed or principal diagnosis on the claim cannot be used as a first listed or principal diagnosis. Review your coding manuals for how to use this code. A different code will need to be billed as first listed or principal diagnosis on the claim.

What is denial code Co 59?

CO 59 – Processed based on multiple or concurrent procedure rules. Reason and action: This is Multiple surgeries detected, hence confirm with coding guideliness and take the necessity action.

What are group codes PR and co?

Group codes are codes that will always be shown with a reason code to indicate when a provider may or may not bill a beneficiary for the non-paid balance of the services furnished. PR (Patient Responsibility). CO (Contractual Obligation).

Is CO 45 responsible for patients?

Just write it off. Generally this code comes in paid claim. That means claims processed and allowed some amount, due to contract with Insurance we are not supposed to bill patient other than allowed amount. This amount is usually write off amount that what refers by CO 45.

Is PR 45 patient responsibility?

For example a PR-45 defines a balance after the insurance payment or adjustment that exceeds the allowed payment from the insurance carrier and assigns that balance as the patient’s responsibility.

What does CO 59 mean on EOB?

Processed based on multiple or concurrent procedure rules
CO 59 – Processed based on multiple or concurrent procedure rules. Reason and action: This is Multiple surgeries detected, hence confirm with coding guideliness and take the necessity action. Like…to be written off or to bill with appropriate modifier.

What are reason codes?

Reason codes, also called score factors or adverse action codes, are numerical or word-based codes that describe the reasons why a particular credit score is not higher. For example, a code might cite a high utilization rate of available credit as the main negative influence on a particular credit score.

What is denial code pr27?

PR-27: Expenses incurred after coverage terminated.