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9
CO - Contractual ObligationCoding/Billing
Denial Code CO-9: Diagnosis Not Consistent with Procedure
What Does Code 9 Mean?
The diagnosis is inconsistent with the procedure. The ICD-10 code does not support the CPT/HCPCS code billed.
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?
The diagnosis code submitted does not medically justify the procedure performed.
How to Resolve It
- 1Review the diagnosis coding for accuracy
- 2Ensure the ICD-10 code supports the procedure
- 3Add or correct the diagnosis code and resubmit
- 4Request clinician clarification if needed