CO-186Contractual ObligationPayment Adjustment
CO-186 Denial Code: Level of care change adjustment
Payment adjusted for a level-of-care change during the stay — e.g., acute to skilled, observation to inpatient reconciliations.
Why CO-186 happens
- ●Documented level-of-care transitions inside a single billing period
How to fix a CO-186 denial
- 1
Verify the adjustment matches utilization review determinations; appeal misapplied changes
How to prevent it
Align UR determinations with billing before claim release.
Drowning in CO-186 denials?
OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.