Medical Billing Forum

Payments => Insurance Payments => Topic started by: mstilger on October 05, 2011, 04:58:58 PM

Title: Medicare denial codes
Post by: mstilger on October 05, 2011, 04:58:58 PM
In layman's terms please what does CO-107, COB-15 & CO-97 mean w/ Medicare :(
Title: Re: Medicare denial codes
Post by: DMK on October 05, 2011, 05:30:07 PM
On the last page of your remittance advice all of the denial code definitions are listed in fairly easy to understand language.

The CO means "contractual obligation" - that would mean what the doctor or facility has agreed to in order to be a Medicare provider. 

Then the number after the CO will be defined.

I've never gotten these codes, so I can't tell you what they are.  But you should be able to get it from the bottom of your remittance advice.

Hope that points you in the right direction!
Title: Re: Medicare denial codes
Post by: mstilger on October 05, 2011, 06:16:13 PM
I know they tell you on the back but there not very easy to read thats why I was wondering if they new if these codes are bundled, global etc. Thanks
Title: Re: Medicare denial codes
Post by: ascbiller on October 05, 2011, 08:25:12 PM
"The remittance advice remark code (RARC) list is maintained by the Centers for Medicare & Medicaid Services (CMS), and used by all payers. Additions, deactivations, and modifications to the code list may be initiated by Medicare and non-Medicare entities. This list is updated three times a year, and posted at http://wpc-edi.com/codes "

From MLN (Medicare Learning Network) Matters Number: MM4314
Release Date: February 17, 2006



Title: Re: Medicare denial codes
Post by: Michele on October 06, 2011, 07:03:07 AM
CO-107   -  this means that they are looking for another service that must be billed with the service that you are billing but it isn't on the claim

COB-15  -  this means that the service was denied or reduced because it is not paid separately from another service performed on the same date

CO-97  -  this means that the payment for the procedure that this is placed next to is included with the allowance for another procedure.  Either they paid another service on the same claim or one was paid in history and they don't allow this code separately from that code (unless there is an appropriate modifier to indicate it should be allowed separately)


Hope that helps!