835 Denial Combination

CO-58

CO

Contractual Obligation · Service-Line Level Adjustment

What This Combination Means

The place of service is inappropriate for the service billed. The procedure cannot be reimbursed in the setting where it was performed.

72%

Appeal Success

7-14 days

Avg. Resolution

Medium

Difficulty

Yes

Appealable

Step-by-Step Resolution

Steps tailored specifically to this CO-58 combination — not generic advice.

  1. 1

    Verify the place of service code matches the actual location of service.

  2. 2

    Check payer policy for allowable POS codes for this CPT/HCPCS code.

  3. 3

    If a POS error was made, correct and resubmit as a corrected claim.

  4. 4

    If the POS is correct but denied, appeal with clinical documentation supporting why this setting was appropriate.

Specialty Context

How CO-58 typically presents across different practice types.

Dental

Verify the place of service is inappropriate for the service billed per your dental plan contract and documentation requirements.

Medical

Confirm the place of service is inappropriate for the service billed against payer policy and submit corrected claim as needed.

Behavioral Health

Apply behavioral health parity rules and confirm the place of service is inappropriate for the service billed per MHPAEA standards.

Individual Code References

View the standalone definition for each code in this combination.

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