CO 175 denial code
Claim adjustment reason code 175. Often reported as CO 175.
Prescription incomplete
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 175 means
The payer will not pay because the order or prescription is missing details it needs.
The order exists but lacks required elements, such as the item description, quantity, length of need, signature or date.
The payer usually wants a complete order before it reconsiders. Find out what is missing and get a corrected order from the prescriber.
Group codes seen with 175
On a remittance, 175 comes after a group code. These are the ones it is most often reported with:
- CO 175 (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
- The prescription lacked a signature or date.
- Required details, such as the quantity, frequency or length of need, were missing.
- The item described on the order did not match what was billed.
What to do next
- Review the order against the payer's requirements for that item.
- Ask the prescriber for a complete, signed and dated order.
- Resubmit the claim or appeal with the complete order.
Related codes
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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