In Medical Billing CO-5 denial code refers as the procedure code or CPT is inconsistent with Place of Service Code (POS code). It means the billed place of service code is not compatible with services performed. In any claim place of service code is an important element, the payment of medical claim depends on the POS, so if we get this denial, we need to handle the denied claim as mentioned below,
Co 5 Denial Code Resolution
- 1st we need to check the which place of service billed and as per system records it is appropriate or not, if not able to clarify, need to consult with coding department.
- If we found correct POS, then we need to rebill claim with corrected information.
- Sometimes we are unable to find the exact solution on system or medical records then need to call insurance ask rep for correct place of service code, if he/she unable to find ask him/her any other hospital claim of same patient available on their record, if yes then check what is correct POS.
- If insurance rep finds reliable and correct information, then request him/her for reprocess the claim.
- If the Insurance rep did not find any info, then need to resubmit claim with medical records to prove that the POS billed is correct. Ask rep for correct address, fax number, timely filing limit of correct claim and also appeal limit.
- Medicare does not accept the corrected claim, so we need to send fresh claims to Medicare.