CO-94Contractual ObligationPayment Adjustment
CO-94 Denial Code: Processed in excess of charges
The allowed/paid amount would exceed billed charges, so the payer capped at charges — often signals underpricing in your charge master.
Why CO-94 happens
- ●Charge master price below the payer's fee schedule
- ●Billed amount keyed too low
How to fix a CO-94 denial
- 1
Post the payment; flag the code/payer pair for charge master review
How to prevent it
Annual charge master review against top payer fee schedules — price at or above the highest allowable.
Drowning in CO-94 denials?
OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.