CO-97+M2

Step-by-Step Resolution

Steps tailored specifically to this CO-97+M2 combination — not generic advice.

1. 1

   If wrong date of service was billed, suppliers may do a self service reopening in the Noridian Medicare Portal. When provided within 2 days prior to anticipated discharge to home, the discharge date must be billed

2. 2

   If beneficiary was not inpatient on date items were provided, contact the facility to update their billing. You can find the NPI of the facility through the claim status page under expanded denial details of the NMP for that specific claim. Once that billing update is verified through Self Service, supplier can either do a self service reopening or rebill the claim for the correct date of service.

Specialty Context

How CO-97+M2 typically presents across different practice types.

Individual Code References

View the standalone definition for each code in this combination.

How to Prevent CARC 97 Denials

• ✓

  RARC M15 (Bundled services): If the procedure code has a 'b' status on the Medicare Physician Fee Schedule (MPFS) database, the service should not be billed to Medicare. Check your most frequently billed procedure codes on the First Coast fee schedule lookup tool — if status is 'b', do not bill Medicare.

• ✓

  RARC M144 (Pre/post-operative care): If billing for split care, coordinate split-care billing activities with other provider(s) involved in the patient's care, and ensure the surgical code is billed before the services for post-operative care are billed.

• ✓

  RARC N70 (Consolidated billing): Before providing services to a Medicare beneficiary, determine if a home health episode exists. Ask the beneficiary if they are receiving home health services under a home health plan of care. Always check beneficiary eligibility prior to submitting your claim via SPOT.