Denial codes / CO-237
Denial code 237CO-237: Legislated or regulatory penalty
Legislated/Regulatory Penalty.
What to doNormal PPO write-off (check the amount)
Recoverable?Usually not
The letters in front matter. CO means the office can't bill the patient for the amount; PR means the patient may owe it; OA and PI are other adjustments. Some numbers can appear with more than one, so read both parts.
Why dental offices see it
- A reduction the insurer applied because a law or regulation requires it (Medicare's quality-program adjustments use this code).
What to do
- Read the remark code on the line: it says which program or rule applied.
- This is a reduction, not a denial, and not money the insurer owes.
- If the program shouldn't apply to you, follow that program's own review process (verify with the insurer).
Stop it next time
Check each year which reporting programs apply to your practice.
How many CO-237 claims are in your report? The free check (free account) counts them, ranks them by dollars and deadline and drafts the letter. It runs in your browser; nothing is uploaded.
Plain-English paraphrase; the official code list is maintained by X12. Insurer rules vary; check the insurer's provider manual. Not legal advice.