CO-97 Remark N19

[TXBiller]

Can someone please help me figure this out?  I don't understand what it's telling me.

OV 99214 received CO-97 with remark N19 from BCBS of Texas

CO-97  Payment adjusted because the benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.

N19  Procedure code incidental to primary procedure

TIA

[Sriram_Sub]

What other service was billed on the DOS?

[Michele]

Yes, we need to know the other services billed.

[kristin]

A CO-97 denial code means that the line item denied is being bundled into another service rendered on that same DOS, or another service from a previous DOS that the patient is in a global period for. If the line item that denied is unrelated to services on that same DOS, or previous DOS, and can be billed separately, then a modifier is needed to indicate this. But as others said, without knowing what else was billed, there is no way to advise you on what to do next.