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CO-54 - Denial Journal
CARC CO — Contractual Obligation

CO-54

Multiple physicians/assistants are not covered in this case

What This Code Means

The plan doesn’t cover having more than one physician or assistant involved for this type of case.

Common Causes

  • Co-surgeon or assistant surgeon billed without payer-required documentation
  • Multiple providers billed for overlapping roles

How to Resolve or Appeal

  1. Confirm whether the plan allows co-surgery/assistant billing with the right modifier
  2. Appeal with operative notes justifying multiple providers if applicable

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

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