CO 5 Denial Code: The procedure code or type of bill inconsistent with the place-of-service. It means Procedure code is not companionable with the place the health care service provided to patient.
When the procedure code or type of bill is inconsistent with the place of service in the healthcare setting, it signifies a discrepancy between the specific medical procedure being billed and the location where the service was rendered to the patient. This inconsistency can have significant implications in terms of accurate coding and billing, potentially leading to claim denials, payment delays, and compliance issues.
When encountering a CO 5 denial code coupled with the RARC Remittance Advice Remark Code M77, it signifies an issue related to a missing, incomplete, invalid, or inappropriate place-of-service. This denial code points to the necessity of correcting either the place of service designation or adjusting the procedure code in alignment with the specified place of service.
Understanding the CO 5 denial code in medical billing requires comprehension of the following terms::
Procedure code is also called as CPT-Current Procedural Terminology codes maintained by AMA-American Medical Association. Procedure code is a 5-digit codes with descriptive terms for reporting medical services and procedures to patients rendered by healthcare physicians.
The purpose of the procedure code is to provide a
Type of Bill is a 4-digit code and used to describe the type of bill physician submitting to the insurance company.
Each code is defined as follows:
Place of Service also called as POS and it is indicated on field# 24B on the HCFA claim form.
Place of service is a 2-digit codes used to indicate the place the healthcare services were provided by physician to patient. Examples: Home, Hospital, Office, Clinic etc).
Note: We can also reach out to the insurance company’s claims department to verify the correct place of service for a particular procedure code or type of bill reported and act accordingly.
Complete BCBS Prefix List from AAA to ZZZ and A2A to Z9Z with claim mailing…
Complete BCBS Prefix List from AAA to ZZZ and A2A to Z9Z with claim mailing…
Complete BCBS Prefix List from AAA to ZZZ and A2A to Z9Z with claim mailing…
Complete BCBS Prefix List from AAA to ZZZ and A2A to Z9Z with claim mailing…
Complete BCBS Prefix List from AAA to ZZZ and A2A to Z9Z with claim mailing…
Complete BCBS Prefix List from AAA to ZZZ and A2A to Z9Z with claim mailing…
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