What CO-45 means
The charge exceeds the contracted fee schedule or the payer's maximum allowable amount. In most cases this is a contractual write-off, not an error — but appeal when the code was miscategorized or the wrong fee schedule was applied.
Common causes
- Billed amount exceeds the contracted rate (expected write-off)
- Wrong procedure code applied a lower-paying schedule
- Out-of-network rate applied to an in-network provider in error
How to appeal CO-45
Confirm the correct contracted rate applies. If the denial reflects a coding error or the wrong fee schedule was used, correct the claim and resubmit. Purely contractual adjustments are not appealable — they are write-offs per the participation agreement.
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