CO-177
What This Code Means
Patient has not met the required eligibility requirements.
Common Causes
- Patient's coverage wasn't active on the date of service
- Wrong member ID or plan information submitted
- Dependent/relationship status not up to date with the payer
How to Resolve or Appeal
- Re-verify eligibility for the exact date of service
- Confirm member ID and plan details directly with the patient or payer
- Bill any other active coverage found, or the patient per financial policy
Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.