Code CO-152
Problem Description
Payer deems the information submitted does not support this length of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Actionable Fix — Solution Steps
Refer to CPT Code Set: -Verify the maximum units/minutes for the service code billed If units/minutes were reported inaccurately, make appropriate changes and resubmit If units/minutes exceed the maximum duration for the service code billed, review for subsequent coding/modifier If units/minutes exceed the maximum duration and no corrections can be made bill only the maximum, additional time will not be paid
Related Codes in Contractual Obligation
The procedure code is inconsistent with the modifier used. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
The procedure code/type of bill is inconsistent with the place of service. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Claim/service lacks information or has submission/billing error(s). Usage: Do not use this code for claims attachment(s)/other documentation. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
Exact duplicate claim/service (Use only with Group Code OA except where state workers' compensation regulations requires CO)
This directory provides reference information only and does not constitute official legal, medical, or financial billing advice. Always consult the payer's official remittance advice and current coding guidelines.