A remittance advice posts contractual adjustment remark CO-97, indicating the benefit for a service is included in another service already adjudicated. What should the billing team do next?
Select an answer to reveal the explanation.
Short Explanation
CO-97 is the payer’s way of saying “that piece was already inside the other payment.” Do not chase the patient for the bundled bite. Check whether the inclusion is fair; if the service truly stood alone, appeal with proof—otherwise post the adjustment and move on.
Full Explanation
CO-97 signals that payment for the service is considered included in payment for another service. Staff should verify edit and documentation legitimacy rather than balance-billing inappropriately or manipulating claims to bypass inclusion logic. If a separately payable service is supported, an appeal with clinical and coding rationale may be appropriate; otherwise the contractual inclusive adjustment should be accepted in posting.