Denial Codes and Solutions

Most common and top denials in medical billing are listed below- please click on the link below for resolutions of

Denial Code CO 197 payment adjusted for the absence of precertification/authorization Receiving a denial from an insurance company for lack

What is denial code CO 119 – Maximum benefit exhausted/met When it comes to insurance and healthcare coverage, benefit limits

Healthcare providers often encounter denial code CO 109 from Medicare, indicating that the claim or service is not covered by

Denial Code CO 97 – The benefit for the service or procedure is inclusive/bundled in the allowance/payment for another service/procedure

Denial Code CO 96 – Non covered charges Denial code CO 96 Resolution: To address this issue, the first step

Denial Code CO 50 – Non covered services not deemed a medical necessity When an insurance company determines that a

Denial Code CO 31 or PR31 – Patient Cannot be identified as our insured When an insurance company is unable

Denial Code CO 29 – The time-limit-for-filing has expired. Timely filing limits for insurance claims vary depending on the specific

Denial Code CO 27 – (Expenses-incurred-after-coverage-terminated). Denial Code CO 26 – (Expenses-incurred-prior-to-coverage). Coverage related denials in healthcare claims processing are