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245
CO - Contractual ObligationPayment Adjustment
Denial Code CO-245: Provider Performance Pay
What Does Code 245 Mean?
Payment adjusted based on provider performance/quality metrics under a value-based contract arrangement.
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?
Value-based payment adjustment based on quality metrics or shared savings program.
How to Resolve It
- 1Review your quality metric performance
- 2Verify the adjustment matches your value-based contract terms
- 3Dispute if the metrics were calculated incorrectly
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