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Denial code CO-50: what it means and what to do
Denial code CO-50 on your Explanation of Benefits: The insurer says the service was not medically necessary.
Check my letter freeWhat CO-50 means
The insurer says the service was not medically necessary.
CO means contractual obligation: under its contract, the provider is usually responsible for this amount, so an in-network provider generally should not bill you for it.
What to do
Ask your doctor for a letter of medical necessity: your condition, the treatments already tried, and why this service is needed now.
Ask the plan for the clinical criteria it used, and answer each point.
In 2023, 44% of appealed in-network denials in HealthCare.gov plans were overturned (KFF).
Your deadline
Most plans give you 180 days from the denial notice to file an internal appeal. Original Medicare gives 120 days from the Medicare Summary Notice, and Medicare Advantage plans 65 days from their decision. Check the date printed on your letter.
More on this reason: Not medically necessary.
Other denial codes
- CO-197
- CO-198
- CO-15
- CO-16
- CO-18
- CO-97
- CO-4
- CO-11
- CO-29
- CO-96
- CO-204
- CO-119
- CO-167
- CO-55
- CO-242
- CO-22
- CO-109
- CO-27
- CO-26
- CO-31
- CO-45
- PR-1
- PR-2
- PR-3