What CO-151 means
The payer says the submitted information doesn't justify the number or frequency of services billed. Overturnable when documentation supports the units.
Common causes
- Units or frequency exceed the payer's default limits
- Documentation didn't establish necessity for the volume billed
- Medical exception applies but wasn't argued
How to appeal CO-151
Document the medical necessity for each unit/visit, reference any frequency-limit exception in the payer's policy, and appeal with the records supporting the full quantity.
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