835 Denial Combination
CO-197+N95
Contractual Obligation · Claim-Level Adjustment
What This Combination Means
Prior auth required but not on file — N95 confirms the referral or authorization is missing.
60%
Appeal Success
14-30 days
Avg. Resolution
Medium
Difficulty
Yes
Appealable
Step-by-Step Resolution
Steps tailored specifically to this CO-197+N95 combination — not generic advice.
- 1
Review denial details for CO-197-N95 and identify the specific issue.
- 2
Pull the relevant documentation (records, auth, NPI information) supporting this claim.
- 3
Correct the identified error or gather required documentation.
- 4
Resubmit as a corrected claim or submit an appeal with supporting documentation.
- 5
Follow up with the payer within 10-15 business days to confirm adjudication.
Specialty Context
How CO-197+N95 typically presents across different practice types.
Dental
Apply dental billing best practices for CO-197-N95 denial resolution.
Medical
Apply medical billing guidelines for CO-197-N95 denial — verify payer-specific requirements.
Behavioral Health
Apply behavioral health billing standards for CO-197-N95 — confirm MHPAEA compliance.
Individual Code References
View the standalone definition for each code in this combination.
Decode every 835 combination automatically
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