CO-P2: Not Work-Related — Workers' Compensation Not Liable
CO-P2 means WC says the injury is not work-related. Appeal through the WC dispute process if it is, or redirect to health insurance if it is not.
What Does CO-P2 Mean?
When paired with Group Code CO, the WC carrier has denied liability for the claim. The provider cannot bill the WC carrier further for this claim. Redirect to health insurance or appeal through the WC dispute process.
CARC P2 indicates the workers' compensation carrier investigated the claim and determined the injury or illness is not work-related, therefore WC is not liable for payment. This denial requires the provider to redirect the claim to the patient's health insurance or, if the work-relatedness is disputed, to pursue the matter through the WC dispute process.
The carrier may have determined the injury occurred outside of work, the condition is pre-existing and not aggravated by work activities, the claim was submitted to WC in error (e.g., an auto accident injury), or the employer disputed the WC claim.
If the injury is genuinely work-related, the provider should appeal through the state workers' compensation dispute resolution process with documentation establishing the connection between the workplace and the injury. If it is not work-related, redirecting the claim to the patient's health insurance is the appropriate next step.
Common Causes
| Cause | Frequency |
|---|---|
| Injury determined non-work-related The workers' compensation carrier investigated and determined the injury or illness is not work-related, denying liability for the claim | Most Common |
| WC claim denied or contested The workers' compensation claim was denied or contested by the employer or WC carrier as not arising from employment | Most Common |
| Pre-existing condition determination The WC carrier determined the condition is pre-existing and not related to the workplace injury | Common |
| Incorrect WC carrier submission The claim was submitted to the WC carrier but the injury is clearly not work-related (e.g., auto accident, personal injury) | Common |
How to Resolve
- Review the denial reason Understand the WC carrier's basis for the non-work-related determination.
- Gather work-relatedness evidence Compile incident reports, employer reports, and physician opinions.
- Appeal through WC dispute process File a formal dispute with supporting documentation.
- Redirect to health insurance If the injury is confirmed as non-work-related, bill the patient's health insurance.
Appeal through the workers' compensation dispute process with documentation establishing the work-related nature of the injury. Include the accident/incident report, employer's First Report of Injury, witness statements, physician's causation opinion, and relevant workplace records. File with the state WC board if the carrier denies the appeal.
Common RARC Pairings
The RARC code tells you exactly what triggered the CO-P2:
| RARC | Description |
|---|---|
| N381 | Alert: Consult your contractual agreement for restrictions, billing, and payment information. Review the WC denial determination and redirect the claim to the patient's health insurance → |
How to Prevent CO-P2
- Verify the nature of the injury (work-related vs. non-work-related) during patient intake
- Collect both WC and health insurance information at registration
- Confirm the WC claim number and employer details before submitting to WC
- Document the circumstances of the injury thoroughly in the medical record
- Submit claims to the appropriate payer (WC for work injuries, health insurance for non-work injuries)
Also Filed As
The same CARC P2 may appear with different Group Codes:
Related Denial Codes
Sources
- https://x12.org/codes/claim-adjustment-reason-codes
- https://www.cms.gov/medicare/coordination-benefits
- Codes maintained by X12. Visit x12.org for official definitions.