CMS 2026 Alert: Quarterly ICD-10-CM & NCCI updates active.
About Us Editorial Policy Contact RCM Team
🔍 Quick Search
CO-12 Denial Code — Diagnosis inconsistent with the provider type – Denial Journal
← Back to Code Directory
CARC

CO-12

CARC CO — Contractual Obligation Coding/Modifier
Quick Facts
Code
CO-12
Type
CARC
Category
Coding/Modifier
Status
Active

Diagnosis inconsistent with the provider type

What Does This Code Mean?

The diagnosis billed isn’t one this type of provider typically treats or reports.

Common Causes

  • Provider taxonomy doesn't align with the diagnosis category
  • Specialist billing outside their usual scope for this payer

Recommended Next Steps

  1. Verify taxonomy code accuracy
  2. Confirm scope-of-practice alignment with the payer if the denial persists

More Denial Codes to Check

RARC M120 RARC MA38 CARC CO-P9 RARC M136 RARC M58 CARC CO-146 RARC M78 CARC CO-D20 RARC M79 CARC CO-58 RARC N57 RARC MA121

Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.

🏠 Home 🔍 Lookup 📋 Appeals 📖 Guides
Scroll to Top