Healthcare Error Code
Healthcare Insurance / Medical Billing
Claim Adjustment Reason Codes (CARC)

CO-65 | Procedure code invalid

Industry
Healthcare
Canonical
/healthcare/error-codes/co-65/
Last Updated
Feb 25, 2026
Summary

This code indicates that the procedure code submitted is not valid according to payer rules.

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What This Code Means

CO-65 is applied when a procedure code does not meet payer validation requirements. This may relate to outdated, incorrect, or unsupported codes. The issue is administrative rather than a coverage decision. Valid procedure codes are required for accurate adjudication.

Where Users Usually See This Code

  • Claim rejection notices
  • Remittance advice
  • Billing validation reports

Why This Code Appears

  • Invalid or discontinued procedure code used
  • Code does not align with payer system rules
  • Submission format errors

What Typically Happens Next

  • Claim processing stops
  • Reprocessing may be required
  • Payment is delayed

What This Code Is Not

  • It is not a non-covered service decision
  • It is not patient responsibility
  • It is not a contractual adjustment

Troubleshooting Checklist

  • Verify procedure code validity
  • Review coding guidelines
  • Monitor payer updates

Notes And Edge Cases

Procedure code updates occur periodically. Payer systems may lag behind coding changes.

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