CO-117Contractual ObligationMedical Necessity
CO-117 Denial Code: Transport covered only to nearest facility
Ambulance/transport payment is limited to the closest appropriate facility — mileage beyond that isn't covered.
Why CO-117 happens
- ●Patient transported to a farther facility by preference
- ●Mileage billed beyond the nearest-appropriate calculation
How to fix a CO-117 denial
- 1
If the nearer facility couldn't provide the required care, appeal with clinical justification
- 2
Otherwise adjust the mileage difference per the payer's calculation
How to prevent it
Document why the destination facility was the nearest appropriate one on every long transport.
Drowning in CO-117 denials?
OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.