CO-15: Workers Compensation or Property/Casualty Claim
CO (Contractual Obligation)What is CO-15?
CO-15 is a Contractual Obligation code indicating the service should be billed to a workers compensation or property/casualty carrier instead of the health plan. The payer determined the injury or condition is work-related or accident-related.
Why Does CO-15 Occur?
- Diagnosis code indicates a work-related injury (e.g., ICD-10 codes for workplace injuries).
- Auto accident or personal injury claim that should be billed to auto/liability insurance.
- Payer's records show the patient has a workers comp or auto claim for the date of service.
How to Fix CO-15 Denials
- Confirm whether the condition is work-related or accident-related by reviewing the clinical documentation.
- If workers comp applies, submit the claim to the WC carrier with the employer information and injury details.
- If auto insurance applies, submit to the auto liability carrier.
- If the payer is incorrect and the condition is not work/accident-related, appeal with documentation from the treating provider.
CO-15 by Payer
| Payer | Common RARC | Appeal Deadline | Notes |
|---|---|---|---|
| UnitedHealthcare | Varies | 60 days from remittance | Reconsideration required before formal appeal. |
| Anthem | Varies | 365 days from denial notice | Check state-specific provider manual for variations. |
| Aetna | Varies | 180 days from denial | Strict in-network filing enforcement. |
| Cigna | Varies | 180 days from denial | Cigna COB team: 1-800-244-6224. |
| Medicare | Varies | 120 days (redetermination at MAC) | Five levels of appeal starting with MAC redetermination. |
Related CARC Codes
If you are seeing CO-15, check these related codes: CO-16 (claim differs), CO-45 (fee schedule), CO-29 (timely filing).
Common Questions About CO-15
What does CO-15 mean?
CO-15 indicates workers compensation or property/casualty claim. Check the RARC code on the EOB for the specific reason and follow the resolution steps above.
Can I appeal a CO-15 denial?
Yes. Commercial payers allow 60-365 days to appeal depending on the payer. Gather supporting documentation before filing. Medicare allows 120 days for a redetermination request.
Altair catches CO-15 denials before submission with payer routing verification. See how pre-submit claim scoring works.