835 Denial Combination

CO-109

CO

Contractual Obligation · Claim-Level Adjustment

What This Combination Means

The claim was not filed with the patient's primary payer first. Secondary payers require a primary payer EOB before processing.

N/A

Appeal Success

3-10 days

Avg. Resolution

Easy

Difficulty

No

Appealable

Step-by-Step Resolution

Steps tailored specifically to this CO-109 combination — not generic advice.

  1. 1

    Identify the patient's primary insurance from their eligibility record.

  2. 2

    File the claim with the primary payer first.

  3. 3

    Once the primary EOB is received, attach it and file with the secondary payer.

  4. 4

    Update your COB workflow to ensure primary is always filed first.

Specialty Context

How CO-109 typically presents across different practice types.

Dental

Verify the claim was not filed with the patient's primary payer first per your dental plan contract and documentation requirements.

Medical

Confirm the claim was not filed with the patient's primary payer first against payer policy and submit corrected claim as needed.

Behavioral Health

Apply behavioral health parity rules and confirm the claim was not filed with the patient's primary payer first per MHPAEA standards.

Individual Code References

View the standalone definition for each code in this combination.

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