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240
CO - Contractual ObligationPayment Adjustment
Denial Code CO-240: Out of Network Premium
What Does Code 240 Mean?
Payment adjusted because the out-of-network premium has been applied. The patient chose an out-of-network provider, resulting in higher out-of-pocket costs.
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?
Patient saw an out-of-network provider, and the plan's out-of-network benefit applies a higher cost-share.
How to Resolve It
- 1Verify network status with the payer
- 2If provider should be in-network, dispute with contract documentation
- 3Check No Surprises Act protections
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