CO-115: Procedure Postponed, Canceled, or Delayed

What Does CO-115 Mean?

With CO (Contractual Obligation), the CARC 115 adjustment is the provider's responsibility. The payer denied or reduced payment because of the scheduled procedure was started but not completed, or was canceled entirely, and the full billed charges are not payable. 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 115 appears on a remittance when the payer applies an adjustment for procedure postponed, canceled, or delayed. Review the group code and any accompanying RARC codes to understand the full context of this adjustment.

Common scenarios that trigger this adjustment include: the scheduled procedure was started but not completed, or was canceled entirely, and the full billed charges are not payable; The service was postponed or rescheduled but the claim was submitted with the original date of service; The original claim was not voided when the procedure was rescheduled, resulting in duplicate charges. The group code paired with CARC 115 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-115 adjustment and any accompanying RARC codes to identify the specific reason for the denial.
2. Identify the root cause Determine which issue applies: procedure canceled before completion, service not rendered on the billed date, duplicate billing for rescheduled service, among others.
3. Correct the claim Address the identified issue — update the claim data in your billing system to resolve the procedure postponed, canceled, or delayed 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 the complete operative report, anesthesia records, and documentation showing the procedure was completed as billed. Include the correct date of service and evidence that the procedure was not canceled or discontinued.

Common RARC Pairings

The RARC code tells you exactly what triggered the CO-115:

How to Prevent CO-115

• Implement a process to void claims when procedures are canceled or rescheduled
• Use discontinued procedure modifiers (53, 73, 74) when procedures are not completed
• Verify service dates on claims match the actual date the service was rendered
• Train scheduling and billing staff on the workflow for handling canceled and rescheduled procedures
• Track procedure cancellations and ensure corresponding claims are properly handled

Also Filed As

The same CARC 115 may appear with different Group Codes:

Related Denial Codes