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Postoperative Care/Bundled Services - JF Part B

Postoperative Care / Bundled Services

CARC/RARC Description
CO-97 The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
M15 Separately billed services/tests have been bundled as they are considered components of the same procedure. Separate payment is not allowed.


Common Reasons for Message

  • A separate charge is not allowed because this service is part of major surgical (90 global days) procedure

Next Step

  • Verify that surgery was billed correctly and includes appropriate modifiers
  • Previous surgery date can be found using the Noridian Medicare Portal (NMP)
  • A reopening can be performed to add appropriate modifiers
  • Submit an Appeal request - Items or services with this message have appeal rights

Claim Submission Tips

  • Follow instructions on correct use of Modifiers


Last Updated Thu, 22 Dec 2022 19:01:59 +0000