CO-110 Denials Explained: How to Identify, Appeal, and Prevent Them

Denials are a persistent issue for healthcare revenue cycle management (RCM) teams, and CO-110 denials, in particular, can derail claims processing workflows. This denial occurs when the billing date on a claim precedes the service date, causing a payer to reject the claim outright.

In this guide, we’ll break down what a CO-110 denial code means, why it happens, and how to handle it effectively. By the end, you’ll learn actionable strategies for appealing and preventing these denials to safeguard your organization’s revenue.

What Is a CO-110 Denial?

The CO-110 denial code indicates that the billing date listed on a submitted claim predates the date the service was actually rendered. The "CO" prefix stands for "Contractual Obligation," meaning the provider is contractually obligated to address the issue, and the patient is not financially responsible for the denied amount. This type of denial typically arises from simple clerical errors, but its impact on revenue can be significant if not resolved promptly.

Comparison: CO-110 vs Similar Denial Codes

Denial Code	Prefix Meaning	Reason/Description	Who's Financially Responsible
CO-110	Contractual Obligation	Billing date predates service date.	Provider
CO-150	Contractual Obligation	Payer deems service not medically necessary.	Provider
CO-16	Contractual Obligation	Claim lacks required information.	Provider

While CO-110 specifically deals with billing date errors, similar codes like CO-150 and CO-16 relate to medical necessity or missing claim details. The key difference lies in the nature of the error, with CO-110 being a purely administrative issue.

Common Causes of CO-110 Denials

1. Clerical Errors During Claim Entry: Simple data entry mistakes can result in mismatched billing and service dates.
2. Incorrect Automation Settings: Errors in billing software configurations might auto-fill incorrect dates.
3. Incomplete Documentation: Missing or unclear documentation can lead to date discrepancies.
4. Premature Claim Submission: Claims submitted before the completion of services can trigger CO-110 denials.
5. Miscommunication Between Teams: Poor coordination between clinical and billing teams can result in inaccurate claim submissions.

Impact on Revenue Cycle Teams

CO-110 denials can significantly disrupt revenue cycle operations, requiring time and resources to resolve. Here’s a closer look at the financial and operational consequences:

Financial Impact:
- Loss of revenue due to delays in claim processing and reimbursement.
- Increased accounts receivable days, straining cash flow.
- Risk of write-offs if appeals are not submitted or resolved in time.
- Additional costs for denial management, reducing operational margins.

Operational Impact:
- Time-intensive rework on denied claims, diverting staff from other priorities.
- Need for detailed knowledge of payer requirements to address denials.
- Increased coordination among billing, coding, and clinical teams to resolve discrepancies.
- Complex tracking of denial trends and appeal outcomes to prevent recurrence.

To address these challenges, CombineHealth.ai’s AI-powered solutions like Adam (AI Denial Manager) provide RCM teams with the tools to efficiently track, manage, and resolve CO-110 denials, reducing revenue leakage and improving operational efficiency.

Steps To Appeal a CO-110 Denial

Successfully appealing a CO-110 denial requires a structured, methodical approach. Follow these steps:

Step 1: Review the Denial Notice
Carefully examine the Explanation of Benefits (EOB) or Electronic Remittance Advice (ERA) to confirm the denial code and reason.

Step 2: Gather Documentation
Collect all relevant documents, including claim submission records, service documentation, and billing logs, to verify the accuracy of the claim.

Step 3: Verify Eligibility
Double-check the patient’s eligibility and coverage details to ensure the claim adheres to payer requirements.

Step 4: Prepare Appeal Letter
Draft a clear and concise appeal letter, including the corrected billing and service dates, supporting documentation, and a request for claim reconsideration.

Step 5: Submit Within Deadline
Ensure the appeal is submitted within the payer’s required time frame to avoid forfeiting the opportunity for resolution.

Step 6: Track and Follow Up
Monitor the appeal status regularly and follow up with the payer as needed to ensure timely resolution.

How To Prevent CO-110 Denials

Proactive measures can help eliminate CO-110 denials before they occur. Here are some focused strategies:

Front-End Prevention

• Verify Service and Billing Dates: Ensure accurate documentation of service dates and billing timelines during patient registration.
• Cross-Train Staff: Train front-desk and billing staff to identify potential discrepancies before claims submission.

Billing Best Practices

• Double-Check Claims: Implement a second-level review to catch billing date errors prior to submission.
• Educate Staff on Payer Policies: Ensure your team understands specific payer guidelines for claim submissions.

Technology Solutions

• Use Claim Scrubbing Tools: Implement real-time claim scrubbing to detect and correct errors before submission.
• Automate Eligibility Verification: Leverage tools like CombineHealth.ai’s platform to automate checks for accurate claim data.

CombineHealth.ai provides advanced tools to prevent CO-110 denials. Adam (AI Denial Manager) identifies potential errors, while Rachel (AI Appeals Manager) expedites the appeals process when denials occur, increasing resolution rates and improving cash flow.

FAQs

Q1: What does CO-110 mean in medical billing?
CO-110 indicates a denial due to a billing date that predates the service date, requiring correction by the provider.

Q2: Can CO-110 denials be appealed?
Yes, CO-110 denials can be appealed by providing corrected dates and supporting documentation.

Q3: How long do I have to appeal?
The timeline varies by payer, but appeals must typically be submitted within 30-90 days of the denial notice.

Q4: How can I prevent these denials?
Prevent CO-110 denials by verifying service and billing dates, implementing claim scrubbing tools, and training staff on payer guidelines. See our complete guide on denial prevention.