CO-97Contractual ObligationCoding
CO-97 Denial Code: Bundled — included in another service's payment
The benefit for this service is included in the payment/allowance for another service already adjudicated.
Why CO-97 happens
- ●NCCI bundling edit (service is a component of a comprehensive code)
- ●Global surgical package includes the billed E/M or service
- ●Missing unbundling modifier (59, XE/XS/XP/XU) when clinically distinct
How to fix a CO-97 denial
- 1
Check NCCI edits for the code pair
- 2
If clinically separate and documented, resubmit with the appropriate modifier
- 3
Otherwise adjust off — do not bill the patient
How to prevent it
Scrub claims against NCCI PTP edits and global period rules before submission.
Drowning in CO-97 denials?
OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.