CO P9 denial code
Claim adjustment reason code P9. Often reported as CO P9.
No matching CPT or HCPCS code
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 P9 means
On a property and casualty claim, the payer found no CPT or HCPCS code that describes the service billed.
Expect it from workers' compensation or auto medical carriers, since it is limited to property and casualty claims. P9 means the service as billed has no correlating standard procedure code the payer can use, so it could not be priced in the normal way.
Billing it with an unlisted code and a clear description, plus the records, is usually the way forward, but check the payer's and state's rules for unlisted services.
Group codes seen with P9
On a remittance, P9 comes after a group code. These are the ones it is most often reported with:
- CO P9 (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
- A local or proprietary code was used instead of a standard procedure code.
- The service is new and has no assigned CPT or HCPCS code yet.
- The description on the claim did not match any standard code.
What to do next
- Check whether a standard CPT or HCPCS code describes the service.
- Resubmit with the correct code, or with an unlisted code and a clear description.
- Attach the procedure note and any pricing support the payer asks for.
Related codes
- P7 (reason code) Code not in the fee schedule or database
- P18 (reason code) Priced like a similar service
- 16 (reason code) Missing information or billing error
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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