835 Denial Combination

CO-109+N104

CO

Contractual Obligation · Service-Line Level Adjustment

What This Combination Means

Claim was submitted to incorrect Jurisdiction Claim must be submitted to the Jurisdiction listed as the beneficiary’s permanent address with the Social Security Administration

N/A

Appeal Success

7-14 days

Avg. Resolution

Medium

Difficulty

No

Appealable

Step-by-Step Resolution

Steps tailored specifically to this CO-109+N104 combination — not generic advice.

  1. 1

    Submit claim to correct Jurisdiction listed as beneficiary’s permanent address with the Social Security Administration. This can be verified in the Noridian Medicare Portal

  2. 2

    Determine which DME MAC jurisdiction the claim is to be submitted to, based on the permanent address or should it be billed to the Part B Mac Jurisdiction

Specialty Context

How CO-109+N104 typically presents across different practice types.

Dental

Medical

Behavioral Health

Individual Code References

View the standalone definition for each code in this combination.

Medicare Contractor Guidance for CARC 109

FCSO + Noridian

The first step in avoiding the reason code CO 109 is to check what type of insurance coverage the patient has and verify their eligibility status prior to submitting claims to Medicare. If the claim has been filed to Medicare in error, it will be returned as an unprocessable claim and will need to be resubmitted to the correct payer / contractor for payment.

How to Prevent CARC 109 Denials

  • Check what type of insurance coverage the patient has and verify their eligibility status prior to submitting claims to Medicare.

  • Check beneficiary eligibility prior to submitting claims to Medicare.

  • Evaluate the accompanying remittance advice remark code (RARC) to determine the correct payer / contractor of service.

SPOTNoridian Medicare PortalNMP

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