835 Denial Combination

CO-97+N19

CO

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. 1

    Confirm the patient's place of service and whether OPPS packaging applies.

  2. 2

    For outpatient hospital services, ancillary services packaged into the APC rate cannot be billed separately.

  3. 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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