CO-175: Prescription Is Incomplete

What Does CO-175 Mean?

With CO (Contractual Obligation), the incomplete prescription is treated as a provider responsibility. The provider cannot transfer this cost to the patient and must obtain the complete prescription and resubmit. This is the most common group code for CARC 175 because prescription completeness is the provider's obligation under payer contracts.

CARC 175 indicates that the prescription or physician order associated with the claim does not contain all the elements the payer requires for processing. This could mean the prescription is missing a diagnosis, dosage, frequency, duration, prescriber signature, date, or other mandatory components.

This code appears most frequently on claims for durable medical equipment (DME), home health services, and pharmacy items where detailed physician orders are required. The payer cannot adjudicate the claim until a fully complete prescription is on file. This is not a coverage denial — it signals that the documentation supporting the claim needs to be corrected before the payer will process payment.

Common Causes

How to Resolve

1. Identify the missing prescription elements Review the remittance and any accompanying remark codes to determine which specific prescription elements the payer found incomplete.
2. Obtain a corrected prescription Contact the prescribing physician to get a new prescription that includes all required elements such as diagnosis, dosage, frequency, duration, and prescriber identification.
3. Verify face-to-face encounter documentation For services requiring a face-to-face encounter (DME, home health), confirm the prescription documents or references the required encounter.
4. Resubmit the claim Submit the corrected claim with the complete prescription attached, referencing the original claim for reprocessing.
5. Track the resubmission Monitor the claim status to confirm it processes correctly with the updated prescription.

Common RARC Pairings

The RARC code tells you exactly what triggered the CO-175:

How to Prevent CO-175

• Use prescription templates that include all required elements for each payer and service type
• Verify prescriptions are complete with all required elements before submitting claims
• Educate prescribing physicians on payer-specific prescription requirements
• Implement prescription review checklists for DME, home health, and other services with detailed order requirements
• Maintain a reference guide of each payer's prescription requirements for common service types

Also Filed As

The same CARC 175 may appear with different Group Codes:

Related Denial Codes