Insurance will deny the claim as Denial Code CO 4 – The procedure code is inconsistent with the modifier used or a required modifier is missing, whenever the procedure code billed with an inappropriate modifier or the required modifier is missing. Modifier: Modifier is a 2 character alpha numeric or numeric code that are used with […]
Author: wenour
Denial Code CO 109 – Claim or Service not covered by this payer or contractor
Claim will be denied as CO 109 – Claim or Service not covered by this payer or contractor, you must send the claim or service to the correct payer or contractor, When the service is covered under an HMO policy for the date of service billed If patient enrolled in SNF at the time of DME […]
Denial Code CO 97 – The benefit for this service is Included
Insurances will deny the procedure code as CO 97 – The benefit for this service is included in the payment or allowance for another service or procedure that has already been adjudicated with the following reasons: If procedure code billed is inclusive with another procedure code performed on the same day by the same provider. E and […]
Denial Code CO 96 – Non-covered Charges
Whenever claim denied as CO 96 – Non Covered Charges it may be because of following reasons: Diagnosis or service (CPT) performed or billed are not covered based on the LCD. Services not covered due to patient current benefit plan. It may be because of provider contract with insurance company. So when you come across […]
Denial Code CO 50 – These are non covered services because this is not deemed medical necessity by the payer
The Insurance Company will deny the claim as CO 50 – These are non-covered services because this is not deemed medical necessity by the payer, whenever the procedure code is not compatible with diagnosis code billed based on the LCD/NCD-Local Coverage determination/National Coverage determination guidelines. Solution: The denial CO 50 – These are non-covered services because this is not deemed […]
Denial Code CO 24 – Charges are covered under a capitation agreement or managed care plan
If Beneficiary enrolled in Medicare advantage plan or managed care plan, but claims are submitted to Medicare insurance instead of submitting it to Medicare Advantage plan, then the claims will be denied as CO 24 – Charges are covered under a capitation agreement or managed care plan Medicare Advantage Plan also called as Medicare Part C. […]
Denial Code CO 22 – This care may be covered by another payer per coordination of benefits
Before going forward about the denial code CO 22 – This care may be covered by another payer per coordination of benefits, let us understand first what does Coordination of Benefits means. What is COB in Medical Billing? Coordination of Benefit is also called as COB. If patient has more than one payer, then the Coordination of […]
Denial Code CO 18 – Duplicate Claim or Service
Insurance will deny the claims with Denial code CO 18 that is Duplicate Claim or Service for the following reasons: Same Claim or service submitted to the insurance company twice, but the medical service performed only once. Suppose whenever Provider or Billing team submits the same claim or service more than once to the insurance company. […]
Denial Code CO 16 – Claim or Service Lacks Information which is needed for adjudication
Insurance will deny the claim with denial reason code CO 16 accompanied with remarks code, whenever claims submitted with missing, invalid or incorrect information. Denial reason code CO 16 states Claim/Service lacks information which is needed for adjudication and it will be accompanied with remarks codes, which indicates the exact missing information in order to […]
Insurance with Alphabet V – Claims address and Phone Number
Insurances Name – Alphabet V Insurance Claim Address Insurance Phone Number VA HEALTH ADMINISTRATION CENTER PO BOX 469065 DENVER, CO 80246-9065 DENVER CO 80246 9065 888 820 1756 VA MUTUAL BENEFIT LIFE INSURANCE CO. 4480 COX ROAD GLEN ALLEN VA 23060 804 272 1992 VA PREMIER CLAIMS PO BOX 4250 RICHMOND VA 23220-8250 8777391370 VA […]