CO-234
CO · Contractual Obligation
CO-234 Denial Code: Procedure isn't separately payable
The procedure is not separately reimbursable - it is considered part of another service or has a bundled payment status. Similar to CO-97; check whether a modifier or a different code applies.
- Group code
- CO - Contractual Obligation
- Code type
- CARC
- Billable to patient?
- No - contractual write-off
- Appealable?
- Sometimes - if a distinct service was mis-bundled
- Category
- Bundling & NCCI Edits
- Common pairing
- N390
On a remittance
CAS*CO*234*125.00On a paper EOB it shows as CO-234.What CO-234 means
CO-234 indicates the procedure has a payment status that does not allow separate payment (for example a Medicare status-B bundled code), or it is always packaged into another service. Unlike CO-97 (bundled into a specific other line), CO-234 often reflects the code's inherent non-separately-payable status. Verify the code's payment status and whether a different code or modifier is appropriate.
Common causes
- The code has a not-separately-payable or bundled payment status.
- The service is always packaged into another procedure.
- A more appropriate, separately payable code exists for what was done.
How to fix it
- Check the code's payment status indicator on the fee schedule.
- If a separately payable code better describes the service, correct and resubmit.
- If a distinct service is documented, append the appropriate modifier and appeal.
How to prevent it
- Scrub for status-B/bundled codes before billing them standalone.
- Choose separately payable codes where clinically accurate.
- Train coders on payment-status indicators.
Sometimes - if a distinct service was mis-bundledAppealable when documentation supports a distinct, separately payable service with the right modifier. If the code is simply never separately paid, it is a write-off.
Linked CMS edit: Payment status indicatorOften reflects a non-separately-payable status (for example Medicare status 'B') on the fee schedule. Check the code's status indicator before billing it standalone.