CO-183
The referring provider is not eligible to refer the service billed
What This Code Means
The payer’s records show the referring provider isn’t eligible/enrolled to make referrals for this type of service.
Common Causes
- Referring provider not enrolled with the payer
- Referring provider's NPI entered incorrectly
How to Resolve or Appeal
- Verify the referring provider's enrollment status with the payer
- Correct the referring provider information and resubmit
Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.