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5
CO - Contractual ObligationCoding/Billing
Denial Code CO-5: Procedure Not Consistent with Place of Service
What Does Code 5 Mean?
The procedure code/bill type is inconsistent with the place of service. The billed location does not match where the service should be performed.
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?
Incorrect place of service code on the claim (e.g., office vs. facility).
How to Resolve It
- 1Review and correct the place of service code
- 2Verify the correct POS for the CPT code billed
- 3Resubmit with the corrected POS
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