CO-60Contractual ObligationContractual
CO-60 Denial Code: Outpatient services within inpatient window
Outpatient charges fall inside the payer's pre-admission/post-discharge window (e.g., Medicare's 3-day payment window) and are bundled into the inpatient stay.
Why CO-60 happens
- ●Diagnostic services within 3 days before an admission billed separately
- ●Related outpatient care billed by a wholly owned/operated entity during the window
How to fix a CO-60 denial
- 1
Combine the services onto the inpatient claim (or let the facility bill them) and void the outpatient claim
- 2
If unrelated to the admission, apply the payer's exception coding (condition code 51 for Medicare) and rebill
How to prevent it
Run payment-window edits that flag outpatient claims near inpatient admissions.
Drowning in CO-60 denials?
OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.