CO-150 denial code
The payer thinks the documentation supports a lower level or intensity of service than the one billed.
“Payer deems the information submitted does not support this level of service.”
Start 10/31/2002 · Last modified 09/30/2007 · X12 adjustment reason code list
What it usually means in behavioral health
CO-150 can reflect a coding judgment or a level-of-care judgment; the remark code and the payer's explanation tell you which.
On the coding side it often lands on time-based psychotherapy. CPT's time rules put 90837 at 53 minutes or more, so a note without clear start and stop times, or with fewer minutes, invites a downgrade.
Common causes
- Documented psychotherapy time doesn't support the billed code, or start and stop times are missing
- Evaluation and management elements don't support the billed E/M level
- Level-of-care documentation supports a lower intensity than the one billed
Correct and resubmit, or appeal?
If the note genuinely supports a lower code, correct and rebill at that level. If it supports what you billed, appeal with the note mapped line by line to the code's requirements.
What to do
Read the note against the code's requirements, especially time for psychotherapy codes.
Rebill at the supported level, or appeal with the mapping if the billed level is supported.
If the pattern repeats, audit a sample of notes for the same code before the payer does.
Often seen with
- N130
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