CO-107: Related or Qualifying Service Not Identified

What Does CO-107 Mean?

With CO (Contractual Obligation), the CARC 107 adjustment is the provider's responsibility. The payer denied or reduced payment because of the billed treatment or procedure requires a qualifying diagnostic test or service to support coverage, but the diagnostic claim was not found in the payer's records. The patient is not liable for this amount. If the denial is in error, the provider can correct and resubmit the claim or file an appeal with supporting documentation.

CARC 107 is used when the payer determines that related or qualifying service not identified. The claim could not be processed as submitted because required information was absent, incomplete, or did not meet the payer's submission standards.

Common scenarios that trigger this adjustment include: the billed treatment or procedure requires a qualifying diagnostic test or service to support coverage, but the diagnostic claim was not found in the payer's records; The billed follow-up service (such as post-operative care) requires a corresponding primary procedure claim, which was not submitted or adjudicated; The qualifying service was submitted under a different patient ID, member number, or provider number, preventing the payer from linking the claims. The group code paired with CARC 107 determines who bears the financial responsibility — CO places it on the provider as a contractual obligation, OA indicates a coordination of benefits or other payer adjustment, PR shifts it to the patient.

Common Causes

How to Resolve

1. Review the remittance details Examine the CO-107 adjustment and any accompanying RARC codes to identify the specific reason for the denial.
2. Identify the root cause Determine which issue applies: missing qualifying diagnostic service for treatment claim, related surgery or initial service claim not on file, prior claim adjudicated under different patient ID, among others.
3. Correct the claim Address the identified issue — update the claim data in your billing system to resolve the related or qualifying service not identified problem.
4. Resubmit the corrected claim Submit the corrected claim following the payer's resubmission guidelines. Include any supporting documentation that addresses the denial reason.
5. Appeal if the original claim was correct Appeal with documentation showing the qualifying service was rendered and submitted. Include the qualifying service claim number, date of service, procedure code, and evidence of the clinical relationship between the two services. If the qualifying service was submitted under different identifiers, provide the correct cross-reference information.

Common RARC Pairings

The RARC code tells you exactly what triggered the CO-107:

How to Prevent CO-107

• Ensure qualifying diagnostic or primary procedure claims are submitted and adjudicated before dependent service claims
• Use consistent patient and provider identifiers across related claims to enable payer linking
• Track claim dependencies and submit related claims in the correct sequence
• Verify payer-specific requirements for qualifying services before submitting dependent claims
• Implement claim tracking systems that flag dependent claims when the qualifying claim is missing or denied

Also Filed As

The same CARC 107 may appear with different Group Codes:

Related Denial Codes