A modifier the payer needed was missing from the procedure.
A correction, not an appeal
Work out which modifier is missing before resubmitting. It is usually a laterality modifier, or one that separates two services billed the same day. Correct and resubmit; there is no decision here to appeal.
N822 commonly rides alongside these. Our reading, not a published mapping: X12 publishes no adjustment-to-remark table.
| Code | What that one means |
|---|---|
| CO 16 | Something the payer needed was missing or wrong on the claim. |
| CO 4 | The procedure code and the modifier do not agree. |
| CO 236 | This procedure and another one billed the same day cannot be billed together under NCCI. |
Upload your denial export 4 columns. No patient data. One page back.