The 10 most common denial codes and what each one actually means
A denial code is a diagnosis, not a verdict. Here is what the ten you will see most often are really telling you, and what the fix is for each.
Resources
Resources for practice owners
Everything here is free and none of it requires a form. If it is useful, use it.
A/R calculator
Estimate the annual revenue lost to unappealed denials, aged receivables and claim rework, benchmarked against MGMA and HFMA ranges.
Run the calculatorBlog
Denials, coding, credentialing and practice economics, written by named credentialed people and updated rather than left to rot.
Read the blogGlossary
Sixty-plus billing terms defined in plain English, each linked to the part of the cycle it belongs to.
Open the glossaryCase studies
What changed for practices that moved their billing, with the numbers before and after and a stated measurement window.
See case studiesHIPAA compliance
The specific safeguards we apply to protected health information, written so your IT team can check them.
Read the detailPublished pricing
What billing costs in this industry, what we charge, and exactly what changes the number. No form to see it.
See pricingLatest writing
Newest first, with a named author and a last-updated date on every post.
How to appeal a medical necessity denial (CO-50)
CO-50 is a coverage policy decision, not a coding error — which means it is appealable, and a well-structured appeal wins far more often than practices expect.
CO-197: what a prior authorisation denial really costs
Most denials are recoverable. CO-197 frequently is not — and in many contracts you cannot bill the patient either. That makes it the most expensive denial category there is.