CO-109
Claim not covered by this payer/contractor — send to correct payer
What This Code Means
This payer is not responsible for the claim; it should be directed to a different payer or contractor.
Common Causes
- Wrong payer ID submitted
- Patient has a different plan administrator than expected
- Claim sent to the wrong Medicare Administrative Contractor (MAC)
How to Resolve or Appeal
- Verify the correct payer/contractor for the patient's plan and service area
- Resubmit the claim to the correct payer
- Update the patient's insurance record in your system
Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.