CO 107 denial code
Claim adjustment reason code 107. Often reported as CO 107.
Related claim or service not identified
Unofficial reference. This is our own plain-English explanation, not the official code text. Payer rules differ. Verify with the payer and the official X12 code list. AlphaPrefix is not affiliated with X12, CMS or any payer. Data last updated .
What 107 means
The payer could not pay because a claim or service that this one depends on was not identified.
Some services are payable only when tied to another qualifying service, such as an add-on code that needs its primary procedure, or a technical service that needs a related professional claim. The payer could not find or match that qualifying service.
Look for a policy reference at the service line, which may name the rule. Often the related service was billed on a different claim or under a different provider.
Group codes seen with 107
On a remittance, 107 comes after a group code. These are the ones it is most often reported with:
- CO 107 (Contractual Obligation): The provider's side of the ledger. The reduction comes from the payer contract or a rule the provider has to follow, and the patient normally cannot be billed for it.
The payer chooses the group code for each adjustment, so the same reason code can appear with another group code on your remittance. Read the two together. More about group codes.
Common causes
- An add-on code was billed without its primary procedure on the same claim.
- The qualifying service was billed by another provider and not yet processed.
- The claim did not include the reference to the related or original claim the payer needed.
What to do next
- Identify the qualifying service the payer requires for this line.
- Bill the primary or related service if it was missed, or wait for it to process and request a reopening.
- Add the related claim reference or prior authorization number if the payer requires it.
Related codes
- 97 (reason code) Service included in another payment
- 16 (reason code) Missing information or billing error
- 204 (reason code) Not covered under the patient's plan
Source
Official wording: X12 Claim Adjustment Reason Codes list. The explanation on this page is our own plain-English wording, not the X12 text.
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