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45
CO - Contractual ObligationPayment Adjustment
Denial Code CO-45: Charges Exceed Fee Schedule
What Does Code 45 Mean?
Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement. The billed amount is greater than the payer's allowed amount.
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?
Standard fee schedule reduction. The payer pays the lesser of billed charges or the contracted rate.
How to Resolve It
- 1No action needed if the write-off is correct per contract
- 2Verify the fee schedule is being applied correctly
- 3If incorrect, appeal with the contracted rate documentation
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