Denial Code CO 146 | Description, Reasons, Next Steps & How To Avoid It
CO 146 means that the insurance company has denied the claim because the diagnosis code(s) provided on the claim form does not support the medical necessity of the service(s) rendered.
The description of CO 146 is “Payment denied due to the diagnosis code(s) reported on the claim.”
Common Reasons for Denial CO 146
- Incorrect or invalid diagnosis code(s) submitted on the claim.
- Diagnosis code(s) does not match the procedure code(s) or service(s) provided.
- Diagnosis code(s) does not support the medical necessity of the service(s) rendered.
- Use of outdated or deleted diagnosis code(s).
Next Steps
- Review the claim and verify the diagnosis code(s) submitted. Ensure that the correct and valid code(s) are used.
- Check if the diagnosis code(s) support the medical necessity of the service(s) rendered. If not, update the code(s) accordingly.
- Resubmit the corrected claim to the insurance company for reconsideration.
- If the denial is upheld after resubmission, consider appealing the decision by providing additional documentation to support the medical necessity of the service(s) rendered.
How to Avoid Denial CO 146 in the Future
- Ensure that the diagnosis code(s) submitted on the claim form are accurate, valid, and up-to-date.
- Verify that the diagnosis code(s) support the medical necessity of the service(s) rendered.
- Regularly update your knowledge of diagnosis coding guidelines and changes to ensure compliance with industry standards.
- Implement a thorough claim review process to catch errors before submission.
