CARC · CO group
CO-151
Payer deems the information submitted does not support this many services
Contractual obligation; provider write-off unless appealed
- What it means
- Frequency or units exceed what the payer will accept for that period.
- Likely cause
- Twice-weekly therapy without authorization, or units billed on a code the payer treats as once-per-day.
- How to fix it
- Appeal with the treatment plan justifying frequency, or obtain authorization prospectively for higher-frequency care.
- Revenue impact
- Recoverable with clinical documentation; commonly abandoned instead.
- frequency
- units
- authorization
Related codes
Early access
Seeing a lot of these?
Repeated CO-151 adjustments usually point to a step before submission. First Pass Paid is building pre-submission checks and a denial worklist to catch these earlier.
Join the early access list