What does denial code CO-109 mean?

Not covered by this payer: send to the correct payer. The claim was sent to the wrong payer or contractor.

How do I fix a CO-109 denial?

Verify which payer administers the plan. Submit to the correct payer.

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Claim adjustment reason code · Contractual obligation

CO-109
Not covered by this payer: send to the correct payer

What CO-109 means

The claim was sent to the wrong payer or contractor.

The CO group code means this amount is a contractual obligation: under most contracts you cannot bill it to the patient.

Common causes

Patient's plan managed by another company
Wrong Medicare contractor or Medicaid plan

How to fix it

Verify which payer administers the plan
Submit to the correct payer

Check the remark code (RARC) that came with the denial and the payer's own policy, since rules vary by payer and plan. This is a plain-English summary written by GetMax; the official code text is published by X12 at x12.org/codes.

Prevent it next time

Most denials are caused before the claim is sent. See 12 ways to reduce claim denials, or let our denial management team work them for you.

Other codes

All denial codes →

Let us work your denials.

We triage every denial by code and payer, fix or appeal it, and stop it repeating.

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CO-109Not covered by this payer: send to the correct payer