CO-185
The rendering provider is not eligible to perform the service billed
What This Code Means
The payer’s records show the rendering provider isn’t eligible/credentialed to perform this specific service.
Common Causes
- Provider's scope of practice doesn't cover this service per payer policy
- Credentialing for this service type not yet complete
How to Resolve or Appeal
- Confirm scope-of-practice and credentialing requirements with the payer
- Bill under a qualifying provider if appropriate, or complete credentialing
Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.