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219
CO - Contractual ObligationCoding/Billing
Denial Code CO-219: Lab/Pathology Inclusion
What Does Code 219 Mean?
Payment adjusted because the laboratory or pathology service is included in the allowance for the primary procedure.
Group Code CO (Contractual Obligation): The provider has agreed to accept the payer's determination. The patient is generally not responsible for this amount.
Why Does This Happen?
Lab or pathology service is bundled into the surgical or primary procedure payment.
How to Resolve It
- 1Review bundling rules for the primary procedure
- 2If truly separate, use modifier -59 with documentation
- 3Verify CCI/NCCI edits for the code pair
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