Denial Codes - Healthcare

CO 13 and CO 14 Denial Code

Channagangaiah
CO 13 Denial Code – The date of death precedes the date of service.

Insurance will deny the claim with CO 13 denial code – the date of death precedes the date of service, when the service billed leads the date of death of a patient.

We need to look into following steps to resolve the CO 13 denial code:

  • First verify the date of service by checking the medical reports of that patient.
  • If the date the service billed is incorrect, then correct and resubmit the claim as new claim.
  • Suppose if the date of service is correct but the record on the file (Date of death date) is incorrect, then patient’s family need to be contacted (We need to inform patient’s famile to contact Social Security office to have the records corrected).
What to be done when we get CO 13 Denial Code – The date of death precedes the date of service for DME services?

Most of the time we come across this CO 13 denial code, when we bill for rental DME (Durable Medical equipment) services.

  • If its rented DME services and the claim denied with CO 13 denial code, then first step is to check the Date of service submitted is correct?
  • If the Date of Service and Date of Death are correct, then the next step is to verify that the rental Durable Medical Equipment has been picked up from patient? If it’s not yet picked up, then the next step is we need to inform provider for pick up the equipment.
  • Final step is to adjust off the balances and write off the charges (Date of service) billed after the patient date of death.
CO 14 Denial Code – The date of birth follows the date of service.

Insurance will deny the claim as CO 14 denial code – the date of birth follows the date of service, when the service billed is before the date of birth.

In this case we need to look into following steps to resolve CO 14 denial code – the date of birth follows the date of service:

  • First verify the date of birth entered is correct by checking the patient registration form or insurance card copy. If date of birth entered is incorrect, correct and resubmit the claim as corrected claim.
  • If Date of Birth entered is correct, then we need to verify the date of service by checking the medical report of patient. If it’s incorrect, then enter correct DOS and resubmit as new claim.

For the above two denial code demographic entry team plays a very important role, suppose assume patient date of birth or the date of service billed is incorrect. Then we end up the claim with denial code 13 or denial code 14.

For example:

Assume Chris date of birth 11/28/2019, but demographic team keyed the claim incorrectly and billed the claim with the date of service 11/15/2019 instead of 12/15/2019.

Here patient date of birth is 11/28/2019 and the date of service reported is before the date of birth. In this case claim will be denied by insurance company with CO 14 denial code – the date of birth follows the date of service. Demographic entry team should be careful while keying the details in the application in order to get rid of these denials.