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CO-222 Denial Code: Exceeds Maximum Allowable Amount
A CO-222 denial occurs when the amount billed for a service exceeds the payer’s maximum allowable reimbursement under the patient’s insurance plan o...
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CO-109 Denial Code: Claim Not Covered by This Payer
A CO-109 denial occurs when a payer determines that a submitted claim is not covered under the patient’s insurance plan. This type of denial often a...
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CO-107 Denial Code: Not a Covered Charge by Payer
A CO-107 denial occurs when a payer determines that a billed service is not a covered charge under the patient’s insurance plan. Unlike medical nece...
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CO-40 Denial Code: Services Not Covered by Payer
A CO-40 denial occurs when a payer determines that a billed service is not covered under the patient’s insurance plan. This can happen even if the s...
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CO-236 Denial Code: Procedure Not Separately Payable Due to NCCI Edits
A CO-236 denial occurs when a procedure or combination of procedures and modifiers submitted on a claim is considered “Not Separately Payable.” This...
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CO-256 Denial Explained: Procedure/Place of Service Mismatch
A CO-256 denial occurs when the procedure billed does not match the place of service (POS) reported on the claim. Payers require that the CPT/HCPCS ...
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CO-242 Denial Code For The Service Not Medically Necessary
A CO-242 denial occurs when a payer determines that a billed service or procedure is not medically necessary for the patient’s condition. This denia...
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CO-167 Denial Explained: Diagnosis Not Covered by Payer Policy
A CO-167 denial occurs when the diagnosis code associated with a billed service is not covered by the patient’s insurance plan, as per payer policy ...
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