Thursday, June 24, 2010

Adjustment code - CO and CR - What does it mean

Adjustment Group Code Glossary for "CR"

CR - - Correction to or Reversal of a Prior Decision

A CR group code is used whenever there is a change to a previously adjudicated claim. CR explains the reason for the correction; PR, CO and/or OA must always be used in tandem with CR to show the revised information. Separate reason code entries must be used in the NSF for the CR group entry, and any other groups that apply to the readjudicated claim.

What is explanation for denial adjustment group code of CO

CO - Contractual Obligations

A CO group code identifies amounts for which the provider is financially liable. These include, participation agreement violations, assignment amount violations, excess charges by a managed care plan provider, late filing penalties, Gramm-Rudman reductions, or medical necessity denials/reductions. The patient may not be billed for these amounts.

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