co 23 denial code meaning and description

CO 23 Denial Code Description and Solution (2024)

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Wondering what a CO 23 denial code or denial code OA23 means or how can it affect you? Or what is the real CO 23 denial code description?

So many questions might trigger your mind if you have come to know about it for the first time. Well to let you know, here are some of the top-discussed information about CO 23 listed below which may help you in the future.

Table of Contents

What is Denial Code CO 23 or OA 23?

Before we discuss how this code would affect, the best thing that we can do first is to know what is denial code co 23 and how does it work?

“CO 23 Denial code-Indicates the impact of prior payers(s) adjudication, including payments and/or adjustments“

As you know when a claim is submitted to secondary insurance for balance, they would process and allow the claim according to the fee schedule.

For instance, when the primary insurance payable amount is lower than the Secondary one and the primary allowed amount is greater than the secondary one. In this case, the secondary insurance would allow the difference between the secondary allowable amount and the primary paid amount as their net allowable amount and remaining balance they will deny with CO 23 denial code.

In other words, the CO 23 denial code descriptions means the impact of prior payer adjudication including payments and adjustment.

What is the patient’s portion and what information is needed?

The information which patients need to have includes their name, address, date of birth, age, marital status, information related to the insurance, and their employment or work details as well.

Besides that, the other information required might include service and billing information, hospitalization dates, Tax ID numbers, NPI, and more.

What can you do when a claim is denied with CO 23 denial code?

If your claim is denied with the co-23 denial code or denial code oa23, then here is what you can do.

  • First, try to ascertain the pending balance with secondary.

If it is in the primary, then try to contact the insurance service provider to reprocess it.

  • If it’s from secondary insurance, then check the fee schedule of secondary to know the allowable.
  • Make sure that the primary insurance paid is less than the secondary insurance amount and the primary insurance allowed amount is greater than the amount allowed for secondary insurance.
  • Thereafter, examine the net allowed amount of secondary insurance and how it has been adjusted. Whether net allowed amount is paid or is it applied to patient responsibility.

OA 23 denial Code Descriptions Meaning:

“Indicates the impact of prior payers(s) adjudication, including payments and/or adjustments. “

Explanation of OA 23 Denial Code- The Remit Code 23 or OA 23 means payment adjusted due to the impact of prior payer(s) adjudication including payments and/or adjustments); and Claim Adjustment Group Code OA (Other Adjustment). Code OA is used to identify this as an administrative adjustment. It is essential that any secondary payer report in the remittance advice only the primary amount that has actually impacted their secondary payment. In many cases, this “impact” is less than the actual primary payment.” In these instances, reporting the actual payment would prevent the transaction from balancing. (Reference PDF)

Frequently Asked Questions- FAQs

Q1. What do you mean by denial codes?

Ans. A denial code can be described as the standard messages which are needed to provide details to the medical provider or patient by the insurance service providers related to why a claim is denied.

Q2. Are denied claims recoverable?

Ans. Usually, the research and resubmitting denied claims can be very lengthy and frustrating.
It makes one question why the claim was even denied in the first place. However, the claim is recoverable and totally preventable.

Q3. What are the claim submission errors?

Ans. Most of the common medical coding and billing mistakes that cause claim denials are due to the ambiguity present in the code itself.
Or rather, if the code doesn’t get specifically mentioned as per the standards. Furthermore, if the claim has got some missing information or has not been filed on time, you may see a denial code arriving.

What is Denials Management in Medical Billing? List of Denial Codes

OA 18 Denial Code – Exact Duplicate Claim

CO 109 Denial Code – Service Not Covered by this Payer

CO 97 Denial Code | Bundled Denial in Medical Billing

CO 50 Denial Code | Not Deemed A Medically Necessary Procedure