135Denial Code (CARC)Active
CO 135 Denial Code - Interim Bills Fix & Prevention
CARC 135 means the payer cannot process the claim because it was submitted as an interim bill. Interim bills are partial claims submitted before the entire course of treatment is completed. This code indicates the claim needs to be finalized before processing.
Who Pays: Group Code Liability
With CARC 135, the group code CO typically applies since the claim is not final and requires adjustment. The patient should not be billed for this type of denial, as it is a contractual issue with the claim submission.
Why Claims Get Code 135
- Submitting a claim as an interim bill instead of a final bill.
- Misunderstanding of payer requirements for interim vs. final billing.
- Incorrect claim submission for services that require full treatment completion.
- System error marking the claim as interim instead of final.
- Payer-specific rules not followed for interim billing.
How to Fix & Resubmit
- Verify if the claim was incorrectly submitted as an interim bill.
- Check the payer's policy on interim billing to confirm requirements.
- Gather any necessary documentation to finalize the claim if treatment is complete.
- Resubmit the claim as a final bill once all services are rendered.
- Contact the payer if there is confusion about the billing status.
Corrected Claim or Appeal?
For CARC 135, submitting a corrected claim as a final bill is the appropriate action. An appeal is not necessary unless there is a dispute about the claim's status as interim or final.
Preventing Future 135 Denials
- Ensure claims are marked as final when all services are completed.
- Train staff on payer-specific guidelines for interim and final billing.
- Regularly audit claim submissions for correct billing status.
- Communicate with clinical staff to confirm treatment completion before billing.