115Denial Code (CARC)Active
CO 115 Denial Code: Procedure Postponed or Canceled
Code 115 indicates that the procedure was postponed, canceled, or delayed. This adjustment means that the service wasn't performed as originally scheduled, resulting in the denial of payment for the claim.
Who Pays: Group Code Liability
For code 115, the group code is typically CO, meaning it's a contractual write-off and the patient should not be billed for the postponed or canceled service.
Why Claims Get Code 115
- The patient canceled the appointment or procedure last minute.
- The provider postponed the procedure due to equipment issues.
- Scheduling conflicts led to a delay in service delivery.
- Weather conditions or emergencies caused a cancellation.
- The procedure was delayed awaiting prior authorization.
How to Fix & Resubmit
- Verify with scheduling or clinical staff why the procedure was postponed or canceled.
- Check if the procedure was rescheduled and a new claim needs to be submitted.
- Ensure all documentation supports any rescheduling or cancellations.
- If the procedure was performed later, submit a corrected claim with the new date of service.
- Communicate with the payer if further clarification is needed on the denial.
Corrected Claim or Appeal?
For code 115, submit a corrected claim if the procedure was rescheduled and performed. An appeal isn't necessary if the service was legitimately postponed or canceled.
Preventing Future 115 Denials
- Confirm appointments a day in advance to reduce last-minute cancellations.
- Coordinate with clinical staff to ensure equipment and resources are available.
- Implement a system to handle rescheduling promptly and efficiently.
- Ensure prior authorizations are obtained before the scheduled procedure date.