835 Denial Combination
CO-97+N19
Contractual Obligation · Service-Line Level Adjustment
What This Combination Means
Payment included in another service — N19 indicates the procedure is subject to the outpatient prospective payment system (OPPS) packaging rules.
N/A
Appeal Success
1-3 days
Avg. Resolution
Easy
Difficulty
No
Appealable
Step-by-Step Resolution
Steps tailored specifically to this CO-97+N19 combination — not generic advice.
- 1
Confirm the patient's place of service and whether OPPS packaging applies.
- 2
For outpatient hospital services, ancillary services packaged into the APC rate cannot be billed separately.
- 3
No appeal for correctly packaged services — post the write-off.
Specialty Context
How CO-97+N19 typically presents across different practice types.
Dental
Verify payment included in another service — n19 indicates the procedure is subject to the outpatient prospective payment system (opps) packaging rules per your dental plan contract and documentation requirements.
Medical
Confirm payment included in another service — n19 indicates the procedure is subject to the outpatient prospective payment system (opps) packaging rules against payer policy and submit corrected claim as needed.
Behavioral Health
Apply behavioral health parity rules and confirm payment included in another service — n19 indicates the procedure is subject to the outpatient prospective payment system (opps) packaging rules per MHPAEA standards.
Individual Code References
View the standalone definition for each code in this combination.
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