Denial Code CO-24: Description, Meaning and How to Fix It
The service is covered under a capitation or managed-care arrangement, not fee-for-service.
Official description
Charges are covered under a capitation agreement/managed care plan.
Common cause
The patient is in a capitated plan; the service should not be billed fee-for-service to this payer.
How to fix it
Route the claim per the capitation/managed-care agreement rather than billing it as fee-for-service.
Related denial codes
- CO-22: Another insurer should be billed first under coordination of benefits.
- CO-45: The amount billed is higher than the payer's contracted (allowed) rate. The difference is a contractual write-off, not a patient balance.
- CO-16: The claim is missing required information or has an error. It is almost always paired with a RARC that names the specific missing field.
- CO-97: This service is bundled into another service that was already paid, so it is not paid separately.
- CO-18: The payer received this exact claim/service already.
- CO-29: The claim was submitted after the payer's filing deadline.