Working Down Denials

HomeCare (08/07) Hanna, Sarah

 

Home healthcare facilities and other groups will often receive Contractual Obligation (CO) 16 denial code alerts when submitting Medicare claims. These denial codes result from missing information, such as a facility address, incorrect date spans, and missing modifiers. It is the responsibility of the facility filing the claim to fix the errors to receive Medicare payments, and patients should not be billed for these services if errors are made in the claims submission process. However, in some cases, additional problems may surface in the claim, generating a CO16 denial code, which will require a facility's billing agent to call a Medicare representative to clarify the issue.