CO-15 denial code
CARC 15 was deactivated on May 1, 2018. Payers on the current X12 list report the same problem with other codes.
“The authorization number is missing, invalid, or does not apply to the billed services or provider.”
Start 01/01/1995 · Last modified 11/01/2017 · Stopped 05/01/2018 · X12 adjustment reason code list
X12 no longer lists this code as active. If it appears on a current remittance, ask the payer or your clearinghouse where it comes from, and use the replacement codes below.
What it usually means in behavioral health
Plenty of billing guides still describe CO-15 as a live code. It isn't on the current X12 list, so if a 15 appears on a remittance today, find out where it came from: an old claim, a payer's proprietary code, or a clearinghouse translation.
On current remittances, a missing or mismatched authorization number usually shows up as CARC 197 (absent) or 198 (exceeded), or as A1 or 16 with a remark code such as M62 (missing, incomplete, or invalid treatment authorization code) or N54 (claim inconsistent with authorized services).
Common causes
- An authorization number left off the claim
- A number keyed with a typo, or from a different episode of care
- An authorization issued to a different provider, site, level of care, or service
Correct and resubmit, or appeal?
Almost always a correction, not an appeal: put the right authorization number on the claim, confirm it matches the provider, service, and dates, and resubmit under the payer's corrected-claim rules.
What to do
Read the remark codes on the line; they carry the specific problem.
Confirm the authorization number, provider, service, and dates against the authorization record.
Correct and resubmit, and check the filing deadline is still open.
If your clearinghouse still shows CARC 15, ask whether it is translating payer-specific codes.
Often seen with
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