May/13

10

What is denial CO-223 from Medicare?

Starting with date of service 4/1/13, Medicare starting reducing revenues by 2% to all paid claims nationwide. This is not exclusive to chiropractic. This is due to the government budget cut. When you see the CO-223 denied portion, you will need to write-off this balance and not bill the patient. The patient’s secondary payer will not pay this amount either since it is not considered to be a part of Medicare’s allowed amount. If Medicare is able to retract this denied portion and reimburse the amount to providers in the future, they will include a retraction in your ERA or EOB to show the denial retraction and updated payment amount on a line-level basis. To account for this properly in your practice management system, apply the CO-223 write-off amount separate from the CO-45 write-off amount (two write-offs per paid Medicare claim) and then if a retraction is made of the denial, you will do a negative write-off to document the retraction and post the new payment information.

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