281Denial Code (CARC)Active
CO 281 Denial Code - Deductible Waived, Next Steps
Code 281 indicates that the deductible has been waived according to a contractual agreement. This adjustment shows up on the remittance advice to reflect that the patient’s deductible is not being applied because of specific terms in the provider's contract with the payer.
Who Pays: Group Code Liability
With code 281, the group code CO applies, meaning the adjustment is a contractual write-off. The provider cannot bill the patient for the waived deductible amount.
Why Claims Get Code 281
- The provider has a contract with the payer that includes a waiver of deductibles.
- The service provided is covered under a special arrangement or promotion that waives deductibles.
- A secondary insurance policy is in place that covers the deductible under the primary policy.
- The payer has applied a policy that waives the deductible for certain preventive services.
How to Fix & Resubmit
- Verify the terms of your contract with the payer to ensure the deductible waiver is correctly applied.
- Check the remittance advice to confirm that the adjustment is for the correct amount and service.
- Ensure that any secondary payer information is accurate and up-to-date if applicable.
- Contact the payer if the waiver seems incorrect or if further clarification is needed.
- Document the adjustment as a contractual write-off per your standard accounting procedures.
Corrected Claim or Appeal?
Code 281 typically does not require a corrected claim or appeal since it reflects a contractual agreement. If the waiver seems incorrect, contact the payer for clarification.
Preventing Future 281 Denials
- Review and understand all payer contracts to ensure correct application of deductible waivers.
- Train staff on identifying services that are eligible for deductible waivers under specific contracts.
- Regularly update payer contract terms in your billing system to prevent misunderstandings.
- Ensure accurate entry of secondary insurance details when applicable.