How do I resolve a CO-97+M15 denial?

Identify the global/comprehensive code that was paid on the same claim or within the global period. Check the global surgery indicator for the procedure in question using the CMS Physician Fee Schedule look-up tool. If the service falls within the global period, the write-off is correct — post the contractual adjustment. If the service was for a complication unrelated to the original procedure, append Modifier 24 (unrelated E&M during postop period) and resubmit with documentation. If the service is genuinely beyond the scope of the global package, appeal with clinical notes supporting medical necessity for the separate service.

Can I appeal a CO-97+M15 denial?

Yes. CO-97+M15 denials are typically appealable with a 38% success rate. Resolution difficulty is Hard and typically takes 21-45 days.

835 Denial Combination

CO-97+M15

Contractual Obligation · Service-Line Level Adjustment

What This Combination Means

Service bundled — the separately billed component is part of a global surgical package or comprehensive service code. M15 specifies that a procedure billed separately is already included in the payment for a comprehensive/global code. The global or comprehensive code absorbs the separately billed item.

38%

Appeal Success

21-45 days

Avg. Resolution

Hard

Difficulty

Yes

Appealable

Step-by-Step Resolution

Steps tailored specifically to this CO-97+M15 combination — not generic advice.

1
Identify the global/comprehensive code that was paid on the same claim or within the global period.
2
Check the global surgery indicator for the procedure in question using the CMS Physician Fee Schedule look-up tool.
3
If the service falls within the global period, the write-off is correct — post the contractual adjustment.
4
If the service was for a complication unrelated to the original procedure, append Modifier 24 (unrelated E&M during postop period) and resubmit with documentation.
5
If the service is genuinely beyond the scope of the global package, appeal with clinical notes supporting medical necessity for the separate service.

Specialty Context

How CO-97+M15 typically presents across different practice types.

Dental

Common when a post-op visit is billed within the global period of an extraction or surgical procedure. Check if the service falls within the 90-day global surgical period.

Medical

Routine for surgical follow-up visits billed during the global period. Check whether the visit was for a complication (billable) or routine post-op care (not separately billable).

Behavioral Health

Less common in behavioral health. May appear when individual therapy is billed on the same day as a group session that already includes the clinician's time.

Individual Code References

View the standalone definition for each code in this combination.

CARC 97 RARC M15

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