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CO-A5Contractual ObligationPayment Adjustment

CO-A5 Denial Code: Medicare PPS capital cost outlier

Capital cost outlier amount under Medicare inpatient PPS — institutional payment math.

Why CO-A5 happens

  • Capital outlier threshold exceeded on a high-cost stay

How to fix a CO-A5 denial

  1. 1

    Validate against the capital outlier formula; post accordingly

How to prevent it

Informational — reconcile outliers in contract management.

Drowning in CO-A5 denials?

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