253Denial Code (CARC)Active
Effective 06/02/2013 · Updated 11/01/2013

CO 253 Denial Code - Sequestration Adjustment Help

Code 253 indicates a reduction in the federal payment due to sequestration. This adjustment reflects a mandatory cut in funds, affecting the reimbursement amount for services covered by federal programs.

Who Pays: Group Code Liability

With code 253, the reduction is typically classified under the CO group code, meaning it is a contractual write-off. The patient cannot be billed for this reduction.

Why Claims Get Code 253

  • Federal sequestration policies mandating budget cuts.
  • The claim involves services paid by a federal program subject to sequestration.
  • The provider agreement includes terms adhering to sequestration reductions.

How to Fix & Resubmit

  1. Review the remittance advice to confirm the sequestration adjustment is correctly applied.
  2. Verify that the claim pertains to a federal program affected by sequestration.
  3. Ensure the contractual agreement recognizes sequestration adjustments.
  4. Document the write-off as a contractual obligation in the billing system.
  5. No action is needed to correct the claim, as this is a legitimate adjustment.

Corrected Claim or Appeal?

For code 253, neither a corrected claim nor an appeal is necessary. This adjustment is a legitimate contractual write-off due to federal sequestration.

Preventing Future 253 Denials

  • Stay informed about current federal sequestration policies affecting healthcare payments.
  • Review provider contracts to understand terms related to federal payment reductions.
  • Educate billing staff about the nature of sequestration adjustments to avoid unnecessary appeals.
  • Regularly update billing systems with the latest federal payment guidelines.