Educational Resource

Top 10 Behavioral Health Denial Codes

Understanding why claims get denied is the first step to recovering your revenue. Here are the most common denial codes we see in Illinois behavioral health practices.

CO-4
The procedure code is inconsistent with the modifier used or a required modifier is missing

What It Means

The service you billed doesn't match the modifier attached, or a required modifier wasn't included. Common with time-based CPT codes like 90837.

Common Causes

Missing modifier (95, GT for telehealth), incorrect place of service, or billing a 53-minute code (90837) for a 45-minute session.

Velden Approach

We audit your modifier usage patterns, identify systematic errors, and submit corrected claims with proper documentation to support the service level billed.

High Recovery Potential
CO-16
Claim/service lacks information or has submission/billing error(s)

What It Means

The payer couldn't process your claim because required information was missing or incorrect. This is a catch-all code for data entry issues.

Common Causes

Missing NPI, incorrect subscriber ID, wrong date of birth, missing diagnosis code, or referral/authorization number not included.

Velden Approach

We cross-reference your claims against payer requirements, identify the specific missing element, correct and resubmit with complete documentation.

Very High Recovery Potential
CO-22
This care may be covered by another payer per coordination of benefits

What It Means

The payer believes another insurance should be billed first (primary vs. secondary confusion).

Common Causes

Patient has multiple insurance policies, incorrect order of billing, or payer records don't match your information about coverage primacy.

Velden Approach

We verify COB status with both payers, obtain updated coverage information, and resubmit claims in the correct order with proper COB documentation.

Moderate Recovery Potential
CO-29
The time limit for filing has expired

What It Means

The claim was submitted after the payer's timely filing deadline (usually 90-180 days from date of service, varies by payer).

Common Causes

Claims stuck in denial loops, delayed charge entry, or waiting too long to follow up on initial rejections.

Velden Approach

We document the original submission attempt, gather proof of timely filing, and submit appeals with evidence showing the claim was originally filed within the deadline.

Challenging but Possible
CO-45
Charge exceeds fee schedule/maximum allowable

What It Means

Your billed amount is higher than what the payer allows. This results in a partial payment, not a full denial.

Common Causes

Billed charges exceed contracted rate, out-of-network adjustments, or payer fee schedule updates you weren't aware of.

Velden Approach

We verify correct payment per your contract, identify underpayments vs. contractual adjustments, and appeal when payments don't match agreed rates.

Review Recommended
CO-50
These are non-covered services because this is not deemed a 'medical necessity'

What It Means

The payer doesn't consider the service medically necessary based on the documentation or diagnosis provided.

Common Causes

Insufficient clinical documentation, diagnosis doesn't support the level of service billed, or missing treatment plan justification.

Velden Approach

We gather supporting clinical documentation, craft medical necessity appeals citing payer-specific criteria, and work with your clinicians to strengthen future claims.

Requires Clinical Support
CO-97
The benefit for this service is included in the payment/allowance for another service/procedure

What It Means

The payer considers this service bundled with another service you billed, so they won't pay separately.

Common Causes

Billing E/M with therapy on same day, not using modifier 25 when appropriate, or payer-specific bundling rules you weren't aware of.

Velden Approach

We review bundling edit logic, determine if unbundling is appropriate with documentation, and resubmit with proper modifiers or appeal with clinical justification.

Moderate Recovery Potential
PR-1
Deductible Amount

What It Means

This portion of the claim is applied to the patient's deductible – it's patient responsibility, not a true denial.

Common Causes

Patient hasn't met their annual deductible yet. Common at the beginning of the year when deductibles reset.

Velden Approach

We ensure the adjustment is accurate, verify remaining deductible amounts, and help you implement effective patient collections processes for these balances.

Patient Collection Required
PR-2
Coinsurance Amount

What It Means

This is the patient's coinsurance portion – their share of the cost after deductible. Not a denial.

Common Causes

Standard cost-sharing per the patient's plan. Usually 10-30% of the allowed amount.

Velden Approach

We verify the coinsurance calculation is correct based on contracted rates and help you identify when payers are incorrectly calculating patient responsibility.

Verify Accuracy
CO-197
Precertification/authorization/notification absent

What It Means

The payer required prior authorization for this service and didn't receive it, or the auth number wasn't included on the claim.

Common Causes

Service required prior auth that wasn't obtained, auth number typo, auth expired, or provider wasn't aware auth was needed.

Velden Approach

We obtain retroactive authorizations when possible, appeal with clinical urgency documentation, and help you implement auth tracking systems to prevent future denials.

Challenging but Possible

Seeing These Codes in Your A/R?

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