Denial Code CO-29: Causes, Solutions, and Prevention Tips

Denial Code CO-29 is a frequent reason for claim rejections, representing a common but avoidable issue that can disrupt the cash flow of your physical therapy practice. Effectively managing these denials ensures that your claims are paid on time, supporting the financial health of your business. This blog will guide you through the essentials of CO-29, including its implications, solutions, and strategies for prevention.

What is Denial Code CO-29?

Denial Code CO-29 indicates that a claim has been denied because the time limit for filing the claim has expired. Most payers set specific time frames within which claims must be submitted to be eligible for reimbursement. Claims submitted outside these time limits are automatically denied under CO-29, resulting in lost revenue for the services provided.

Why Does CO-29 Matter?

CO-29 denials can result in significant financial losses as they represent missed opportunities to get reimbursed for services rendered. Understanding the time frames and adhering to submission deadlines is crucial to keeping your practice’s revenue cycle healthy and avoiding unnecessary denials.

Deconstructing a CO-29 Denial: What Went Wrong and How to Fix It

Example:

• Initial Billing:
  • CPT 97110: Therapeutic Exercise
  • CPT 97112: Neuromuscular Reeducation

• Outcome: Both services were denied under CO-29 because the claim was submitted beyond the payer’s allowed filing period of 90 days from the date of service.

Remedy:

1. Review the Denial Notice: Examine the Explanation of Benefits (EOB) or Remittance Advice (RA) to confirm the reason for the denial and the time limits specified by the payer.
2. Check Payer Policies: Verify the payer’s filing limits for claims to understand the specific requirements and deadlines.
3. Appeal the Denial: If there were extenuating circumstances, such as system errors or natural disasters, gather evidence and submit an appeal explaining the delay in submission. Include documentation that supports your case for reconsideration.

• Corrective Action: Ensure all future claims are submitted well within the filing deadlines set by the payer to avoid CO-29 denials.

Actionable Steps: How to Address a CO-29 Denial

1. Verify Filing Deadlines: Before submission, always check payer-specific filing deadlines to ensure compliance.
2. Organize Documentation: Maintain a robust documentation system that includes timestamps of all submitted claims to track and manage deadlines effectively.
3. Appeal When Appropriate: If a denial occurs due to unavoidable circumstances, promptly appeal the denial with proper documentation explaining the delay.
4. Monitor Claims: Implement a claims tracking system to monitor the submission status and ensure claims are submitted within the required time frame.

Common Causes of CO-29 Denials

1. Late Submission: Claims are submitted after the payer’s filing deadline, often due to administrative delays or oversight.
2. Unclear Payer Guidelines: Misunderstanding or lack of awareness of the payer’s specific filing limits can lead to missed deadlines.
3. System Errors: Technical issues with billing systems or clearinghouses that cause delays in submission.

Proactive Prevention: Avoiding CO-29 Denials

Pre-Claim Submission Checklist:

• Check Payer Filing Limits: Familiarize your team with the specific time limits for each payer.
• Submit Claims Promptly: Aim to submit claims as soon as possible after services are rendered, ideally within 30 days.
• Track Submission Dates: Use billing software that tracks submission dates and flags any claims approaching the filing deadline.

Training and Best Practices:

• Regularly train your billing staff on the importance of timely submissions and the specific filing limits of your payers.
• Establish clear protocols for rapid claim submission to reduce the risk of missing deadlines.

Technology and Tools:

• Utilize billing software with automated alerts for approaching deadlines to ensure timely submission of claims.
• Implement a reliable claims management system that tracks the status of each claim from submission to payment.

Conclusion: Protect Your Practice’s Revenue with Expert Denial Management

Denial Code CO-29 can pose a significant challenge, but with a proactive approach and attention to deadlines, your practice can avoid these denials. By understanding payer-specific filing limits, submitting claims promptly, and maintaining accurate tracking systems, you can ensure that your practice gets paid for the services it provides.

Take Action with SPRY

Handling denials like CO-29 doesn’t have to be overwhelming. SPRY’s advanced physical therapy software streamlines the billing process, monitors submission deadlines, and helps ensure that your claims are submitted on time. Schedule a demo today to see how SPRY can improve your billing efficiency and revenue cycle management.

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