Medicare denial code CO 50 , CO 97 & B15

Denial code co – 50 : These are noncovered services because this is not deemed a “medical necessity” by the payer.

Explanation and solution : It means that Medicare thinks that the submitted procedure not required to perform. Check the DX or submit the claims with Medical records.

Denial code CO – 97 : Payment is included in the allowance for the basic service/procedure.

Explanation and solution : It means that payment not paid

seperately. Submit with correct modifier or take adjustment.

Denial code B15 : Claim/service denied/reduced because this procedure/service is not paid separately.

Explanation and solution : The same as above.

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3 Comments.

  1. this was really a big help

  2. quit good material i like it

  3. Balaji Shanmugam

    Thanks for the detail explanation. I really appreciate it.

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