Key Takeaways: CO 45 = “Charge exceeds fee schedule/maximum allowable or contracted rate.” It usually represents a contractual adjustment, not a billable patient balance. Common causes include outdated fee schedules, incorrect coding, or missing modifiers. Prevention requires accurate contract management, claim scrubbing, and staff training. Partnering with Allzone helps healthcare providers streamline denial management and […]
Key Takeaways Denial Code CO-15 occurs when authorization or referral information is missing, invalid, or mismatched. Common causes include expired authorizations, incorrect provider details, or billing mismatches. Prevent CO-15 denials through automation, staff training, and proactive verification. Collaborating with a trusted RCM partner like Allzone Management Services can streamline your authorization process and reduce denials […]
In the complex world of medical billing, claim denials can significantly impact a provider’s cash flow, operational efficiency, and financial stability. One of the most common and often misunderstood denial codes is CO 109. This denial typically arises due to timely filing issues, which means the payer received the claim after the allowed submission deadline. […]
What is CO‑197? In medical claims terminology, CO 197 (or “CO‑197”) is a denial adjustment code used by payers to indicate that a claim (or line item) was rejected because precertification, authorization, or required notification was not obtained prior to providing the service. The “CO” stands for Contractual Obligation — meaning this denial is tied […]
Introduction In medical billing, claim rejections and denials are inevitable—but understanding why they occur is the key to fixing them. One of the most important tools for decoding these denials is the Claim Adjustment Reason Code (CARC). Each CARC provides specific information about why a claim or a service line was adjusted, denied, or paid […]
In the complex world of medical billing, every claim denial tells a story. Among the most common denial codes faced by healthcare providers is CO-29, which indicates a “Claim denied because the filing time limit has expired.” When this code appears on an Explanation of Benefits (EOB) or Remittance Advice (RA), it means the claim […]






