CO-150
Payer deems the information submitted does not support this level of service
What This Code Means
The documentation submitted doesn’t justify the complexity/level of the E/M or service code billed.
Common Causes
- Documentation doesn't support the medical decision-making complexity billed
- E/M level billed higher than what notes support
How to Resolve or Appeal
- Review documentation against the E/M level's MDM or time requirements
- Down-code and resubmit if documentation genuinely doesn't support the level billed, or appeal with additional notes
Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.