What does CO-109 mean?
CARC code 109 means you submitted the claim to the wrong payer. This typically happens when the patient's insurance information has changed, they have a different plan than what is on file, or the payer ID was entered incorrectly. Verify the patient's current insurance information, confirm the correct payer ID and address, and resubmit to the correct payer. This has a high overturn rate of approximately 70% because the fix is simply resubmitting to the right place.
How to appeal CO-109
Check the RARC code
The RARC (Remittance Advice Remark Code) on your ERA provides specific details about why the claim was denied. This tells you exactly what needs to be fixed.
Correct the identified issue
Fix the specific billing or coding error identified. Verify the correction against payer guidelines before resubmitting.
Resubmit the corrected claim
Resubmit with the appropriate frequency code (7 for replacement, 8 for void/resubmit) along with the corrected information.
Key notes for behavioral health
Wrong payer. Verify correct insurance and resubmit to appropriate payer.