reason code. QTY The adjustment to the submitted units of service. This field will not be printed if the value is zero. REMARK CODES The Code List Qualifier Code and the Health Care Remark Code (Remittance Advice Remark Codes). The Code List Qualifier Code is a code identifying a specific industry code list. Values are: HE = Claim Payment Jul 3, 2019 · Feb 22, 2020. #4. OK, so CO-170 means: This payment is adjusted when performed/billed by this type of provider. The CO represents "contract issue" meaning that there may be something in your contract, with that specific insurance company, that is not allowing the NPPs to bill for these services. Contracts are updated by some insurance companies Dec 9, 2023 · Common Reasons for Message. Combination of codes billed on same date of service by same provider may not be appropriately paired together due to National Correct Coding Initiative (NCCI) Edits. Payment for service billed is bundled into payment for another service performed that day. It is unusual for services billed to be performed together.
Insurance coverage is another critical aspect that can result in a CO 252 denial code. Providers must verify the patient's insurance eligibility and benefits before providing services. Failure to do so can lead to claim denials, as the insurance company may consider the services to be out-of-network or not covered under the patient's plan.
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Nov 30, 2017 · 2 / 3: Remark Codes N264 and N575. N264: Missing/incomplete/invalid ordering provider name. N575: Mismatch between the submitted ordering/referring provider name and records. A CO16 denial does not necessarily mean that information was missing. It could also mean that specific information is invalid.
Nov 2, 2021 · If denial code CO-109 occurs in any claims that mean the patient has another payer or insurance and the patient did not update info that which is primary ins and which is secondary ins. Mostly due to this reason denial CO-109 or covered by another payer denial comes. When claim submitted to different region (Other than the beneficiary lives in).
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    • co 22 denial code reason