CO-213Contractual ObligationContractual
CO-213 Denial Code: Self-referral (Stark) non-compliance
Denied for non-compliance with physician self-referral prohibitions (Stark law) or the payer's equivalent policy — a serious compliance flag.
Why CO-213 happens
- ●Referral to an entity with a financial relationship lacking a Stark exception
How to fix a CO-213 denial
- 1
Involve compliance/legal immediately — this is beyond routine appeals
- 2
If an exception applies, appeal with the documented exception
How to prevent it
Standing legal review of all financial relationships with referral sources.
Drowning in CO-213 denials?
OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.