Denial reference

Each denial maps root cause, department ownership, corrective actions, and prevention controls, cross-linked to the standards that address it.

Medical Necessity

CO-50

Not deemed medically necessary

Open reference
Registration

CARC-16

Missing/incorrect information

Open reference
Coding

CO-97

Bundled / included in another service

Open reference
Billing

CO-45

Charge exceeds fee schedule

Open reference
Registration

CO-22

Coordination of benefits

Open reference
Billing

CO-18

Duplicate claim/service

Open reference
Authorization

CO-197

Authorization absent

Open reference
Coding

CO-11

Diagnosis inconsistent with procedure

Open reference
Patient Access

CO-27

Coverage terminated

Open reference