5 Denial Codes For Medical Billing And Their Reasons

5 Denial Codes for Medical Billing and Their Reasons

As a healthcare provider, you know how important it is to have accurate and timely medical billing. However, as much as we strive for perfection, medical billing errors are inevitable. It is important to understand the reasons behind these errors in order to avoid them and get paid accurately and in a timely manner. In this blog, we will discuss five common denial codes for medical billing and their reasons.

List Of Denial Codes in Medical Billing

Denial Code CO-11: Diagnosis Code Does Not Match with the Procedure

This denial occurs when the patient’s diagnosis does not match with the procedure code. It can be avoided by carefully reviewing all codes entered into the system and making sure they are accurate. Additionally, if changes need to be made to a procedure or diagnosis, make sure these changes are noted in the system as well.

Denial Code CO-16: Claim Lacks Information or Has Submission/Billing Errors

When this denial code is received, it means that there are errors in the submission of the claim or the billing process. This could include incorrect diagnosis codes, wrong modifiers, untimely filing, etc. It is important to make sure all information is accurate and up-to-date before submitting a claim.

Denial Code CO-18: Duplicate Billing

This code indicates that the claim was billed twice. This could be an oversight. To avoid this error, always review your claims before submitting them and make sure they are accurate and not duplicates. If this was meant to be a replacement claim, make certain you have selected the frequency as Replacement of prior claim and in Claim Level Information, that you have added the Payers Claim No. for Replacement of claim.

Denial Code CO-27: Insurance Expired

It is important to make sure that all insurance information is up-to-date and correct. If the insurance has expired, the claim will be denied. To avoid this error, always check the patient’s insurance status before submitting a claim.

Denial Code CO-45: Charges Exceed Your Contracted/Approved Amount with the Patient

This code means that the charges for a service or item exceed an agreement between you and the patient. To avoid this, it is important to make sure that all agreements with patients are in writing and that they are aware of what they will be charged before any services or items are provided.

Why Behavioral Healthcare Programs Choose AZZLY

The medical billing process can be overwhelming with all the paperwork and regulations involved. AZZLY® is here to make healthcare more efficient by providing comprehensive substance use billing software for medical organizations, including claim submission and payment processing. Our software is designed to streamline the entire billing process, helping organizations save time and money while getting accurate, timely payments.

With our intuitive interface and advanced analytics, you can easily manage your claims and identify any errors or discrepancies before submitting them for reimbursement. Plus, our secure system ensures that all data is safe and compliant with industry regulations. So, whether you are looking to reduce claim denials or need help navigating the complex world of medical billing, AZZLY has the solutions you need.

To Conclude – Get the Most Out of Your Medical Billing

Medical billing errors can be stressful and costly for healthcare providers. Denial codes are one of the most common causes of medical billing errors, so it is important to understand what these codes mean and why they may be issued. By following the tips outlined in this blog, you will be able to reduce or avoid denied claims for your organization. Plus, with the help of AZZLY, you can further streamline your billing process and ensure accuracy when submitting claims.

If you have any questions or would like to learn more about how AZZLY can help your healthcare programs, contact us today at hello@azzly.com or 1 (888) 400-3201. You can also schedule time on a Solutions Consultant’s calendar here. So get started with AZZLY today and start maximizing your medical billing.