Denial Code CO-97: Description, Meaning and How to Fix It
This service is bundled into another service that was already paid, so it is not paid separately.
Official description
The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.
Common cause
Global surgical packages, incidental procedures, or NCCI bundling edits.
How to fix it
Check whether an unbundling modifier (such as 59 or an X modifier) is appropriate and supported by documentation. If bundling is correct, write it off.
Related denial codes
- CO-234: The procedure is not separately payable; its value is included in another service.
- 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-18: The payer received this exact claim/service already.
- CO-22: Another insurer should be billed first under coordination of benefits.
- CO-29: The claim was submitted after the payer's filing deadline.