CO-65 | Procedure code invalid

What This Code Means

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