CO-5CARCCOContractual ObligationAppealability depends
What it means
The procedure billed does not line up with the place of service code (for example, an inpatient code billed for an office visit).
Contractual Obligation — an adjustment the provider agreed to by contract. The patient is generally not billed for CO amounts.
Official X12 description
“The procedure code/type of bill is inconsistent with the place of service”
Typical cause
A mismatch between the service performed and the facility/place-of-service code on the claim — usually a billing error.
What to do next
- 1Ask your provider's billing office to confirm the place-of-service code and correct it if wrong.
- 2Request a corrected claim be submitted to the insurer.