OakClaim
CO-70Contractual ObligationPayment Adjustment

CO-70 Denial Code: Cost outlier adjustment

Additional payment (or adjustment) compensating for exceptionally high-cost cases under prospective payment — the cost sibling of the day outlier.

Why CO-70 happens

  • Case costs exceeded the fixed-loss threshold for the DRG

How to fix a CO-70 denial

  1. 1

    Validate against the payer's outlier formula; post accordingly

How to prevent it

Flag potential outlier cases early so documentation supports the full cost picture.

Drowning in CO-70 denials?

OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.

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