CO-P15Contractual ObligationWorkers' Comp & Auto
CO-P15 Denial Code: WC medical treatment guideline adjustment
Adjusted under the state's WC medical treatment guidelines (e.g., ODG, state-specific MTGs) — treatment outside guidelines pays differently or not at all.
Why CO-P15 happens
- ●Treatment beyond guideline frequency/duration without variance approval
How to fix a CO-P15 denial
- 1
Request a variance/pre-authorization under the state MTG process; appeal with guideline citations
How to prevent it
Practice to the applicable MTGs for WC patients; request variances prospectively.
Drowning in CO-P15 denials?
OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.