CO B14 denial code
Claim adjustment reason code B14. Often reported as CO B14.
One visit per physician per day
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 B14 means
The payer covers only one visit or consultation by the same physician on the same day, and this one was over that limit.
When a provider bills more than one evaluation and management visit or consultation for the same patient on the same date, many payers pay only one. B14 is the denial for the extra visit.
Separate visits on the same day can sometimes be paid if they were truly distinct and documented that way, often with a modifier or by combining them into one higher level visit, depending on the payer's policy.
Group codes seen with B14
On a remittance, B14 comes after a group code. These are the ones it is most often reported with:
- CO B14 (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
- Two visits for the same patient were billed on the same date by the same physician.
- A consultation and a follow up visit were billed on the same day.
- Providers in the same group and specialty were treated as one physician by the payer.
What to do next
- Check whether both visits were medically distinct and documented separately.
- Combine the work into a single visit at the appropriate level if the payer requires that.
- Resubmit with the modifier the payer accepts for a separate same day service, if applicable.
- Check the payer's policy on same day visits by providers in the same group and specialty.
Related codes
- B16 (reason code) New patient criteria not met
- 97 (reason code) Service included in another payment
- B1 (reason code) Visits not covered
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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