Healthcare Error Code
Healthcare Insurance / Medical Billing
Duplicate / Billing Errors
CO-69 | Day outlier adjustment
Industry
Healthcare
Canonical
/healthcare/error-codes/co-69/
Last Updated
Feb 25, 2026
Summary
This code indicates that an adjustment was made due to an unusually long length of stay or service duration.
Advertisement after-summary
Ad Space
What This Code Means
CO-69 is used when a claim exceeds expected service duration thresholds. Payers apply outlier rules to adjust reimbursement. This reflects payment methodology rather than coverage denial. It does not indicate improper care. Adjustments are based on predefined benchmarks.
Where Users Usually See This Code
- Remittance advice
- Inpatient claim adjustments
- Payment calculation summaries
Why This Code Appears
- Length of stay exceeds norms
- Outlier payment rules apply
- Reimbursement thresholds triggered
What Typically Happens Next
- Payment is adjusted
- Claim processing completes
- No additional review is required
What This Code Is Not
- It is not a denial
- It is not a billing error
- It is not patient responsibility
Troubleshooting Checklist
- □ Review outlier payment rules
- □ Monitor reimbursement calculations
- □ Track payer policies
Notes And Edge Cases
Outlier thresholds vary by payer and program. Policy updates may affect adjustment calculations.
Related Codes
8 links
- CO-45 CodeCharge exceeds fee schedule
- M15 CodeSeparately billed services
- CO-27 CodeCoverage terminated
- CO-170 CodePayment adjusted due to referral absence
- CO-21 CodeMissing/invalid place of service
- CO-26 CodeExpenses incurred before coverage
- CO-33 CodeInsufficient documentation
- CO-54 CodeMultiple physicians not allowed
Advertisement near-bottom
Ad Space