Author Topic: Medicare billing & CO-45 code (Read 4766 times)

kendalb23 · « **on:** May 06, 2015, 08:30:58 PM »

I am getting a Medicare code of CO-45, which looks to me like a denial of payment. I am billing for an optometrist and only have about 6 months of experience, but I'm having a hard time finding any clarification. Help!!

Merry · « **Reply #1 on:** May 06, 2015, 08:34:30 PM »

Are you billing for a refraction? Medicare doesn't cover refractions. Patient needs to pay that part.

ste · « **Reply #2 on:** May 07, 2015, 04:22:33 AM »

Likes to me like:
Contractual Obligation - Charges on the line item exceed those stipulated in the providers contract.

kristin · « **Reply #3 on:** May 07, 2015, 11:49:40 PM »

A CO-45 is usually the amount over the fee schedule that the provider has to adjust off per their contract. If the amount is for the entire charge, there should be another remittance advice code stating WHY they have to adjust it off. Is there one of those also?

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