CO-223 Denial Code Explained

CO-223 is a medical billing denial code that indicates the payer reduced or denied reimbursement because the patient is enrolled in a hospice benefit program. This denial commonly occurs when services are considered related to hospice care coverage.

What Does CO-223 Mean?

The CO-223 denial code means the insurance payer determined the submitted services fall under hospice benefit coverage and may not qualify for separate reimbursement outside the hospice arrangement.

This denial is often related to hospice billing rules and payer coordination requirements.

Common Reasons for CO-223

• Hospice benefit enrollment

• Services related to hospice treatment

• Incorrect payer billing

• Duplicate hospice reimbursement

• Coordination of care issues

• Billing outside hospice coverage guidelines

How To Fix CO-223

Verify the patient’s hospice enrollment status and confirm whether the services are covered under hospice benefits. Review payer billing requirements and coordinate billing appropriately with hospice providers if necessary.

Providers may need to submit corrected billing information or supporting documentation.

Related Denial Codes

You may also encounter:

• CO-22 — Coordination of benefits issue

• CO-96 — Non-covered service denial

• CO-109 — Coverage limitation denial

• PR-204 — Service not covered under patient benefit plan

Quick Summary

CO-223 indicates the payer determined the billed services are related to hospice benefit coverage. Most denials are related to hospice billing rules or coordination requirements.

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