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237
CO - Contractual ObligationPayment Adjustment
Denial Code CO-237: Legislated/Regulatory Adjustment
What Does Code 237 Mean?
Legislated/regulatory penalty or adjustment. Payment reduced based on a government-mandated reduction or penalty.
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?
CMS or state-mandated payment reduction (e.g., HAC, readmission penalty, value-based).
How to Resolve It
- 1Verify which legislative/regulatory provision applies
- 2Review quality measures if related to value-based penalties
- 3Generally not appealable but verify the calculation
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