CO-115 Denial Code: Procedure Postponed or Canceled
CO-115 means the payer denied or reduced the service because the procedure was postponed, canceled, or delayed. If part of the procedure was actually performed, the claim may need a reduced or discontinued service modifier instead of billing the full procedure.
Quick facts
- Code
- CO-115 (CARC 115)
- Status
- Active In use since January 1, 1995; last modified September 30, 2007.
- Code set
- Claim Adjustment Reason Codes (CARC)
- Group codes
-
- CO (Contractual Obligation): The provider absorbs the amount. A canceled or incomplete procedure billed as complete is not billable to the patient.
- PR (Patient Responsibility): Rare. Some plans treat a patient-requested postponement or a missed appointment fee as the patient's responsibility under your financial policy.
- Official description
Procedure postponed, canceled, or delayed.
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026- Last verified
- against the official X12 list.
What CO-115 means
CARC 115 reads procedure postponed, canceled, or delayed. The payer’s information shows the billed procedure did not happen as billed on that date. Sometimes the procedure never started; sometimes it started and was stopped; sometimes it was moved to a later date and the original claim was not updated.
The denial is not about medical necessity. It is about whether the service billed matches what actually took place.
Example: a surgery scheduled for Monday is canceled after the patient is prepped, and is performed on Thursday. The facility bills Monday as a full procedure. The payer denies it with CO-115. The facility should bill Monday with the right discontinued-procedure modifier (if its rules allow) and Thursday as the completed procedure.
Common causes
- A charge created from the schedule for a procedure that was canceled.
- A procedure that started but was stopped, billed without a reduced or discontinued modifier.
- A postponed procedure billed with the original scheduled date.
- An operative or procedure note that states the procedure was aborted or deferred.
- Duplicate charges when a rescheduled procedure was billed on both dates.
How to fix it
- Review the procedure note for the billed date. Confirm whether the procedure was performed, partly performed, or not performed.
- If it was not performed, void the charge. Bill the procedure on the date it was actually done.
- If it was partly performed, send a corrected claim (resubmission code 7 in box 22) with the right modifier in box 24D: 52, 53, 73, or 74, based on setting and payer rules. Include documentation if the payer requires it.
- If it was performed in full on the billed date, appeal with the procedure note showing completion.
- Do not bill the patient for the denied amount unless your financial policy and contract allow a cancellation fee.
How to prevent it
- Generate procedure charges from completed documentation, not from the schedule.
- Reconcile the surgery or procedure log against charges daily.
- Teach coders when to use modifiers 52, 53, 73, and 74, and what documentation each requires.
- Scrub for procedures billed on dates with no completed note. A Claims Validator can help flag unusual modifier and procedure combinations.
Remark codes that may appear with CO-115
- N441 (This missed/cancelled appointment is not covered.): Missed or canceled appointments are not covered by the payer.
- N838 (Alert: Service/procedure postponed due to a federal, state, or local mandate/disaster declaration.): The procedure was postponed because of a government mandate or disaster declaration.
Related and easily confused codes
- CO-203 (Discontinued or reduced service.): Discontinued or reduced service, often paired with modifiers for partial procedures.
- CO-4 (The procedure code is inconsistent with the modifier used.): Procedure code inconsistent with the modifier used, which can follow a wrong reduced-service modifier.
- CO-112 (Service not furnished directly to the patient and/or not documented.): Service not furnished directly or not documented.
- CO-150 (Payer deems the information submitted does not support this level of service.): Information does not support the level of service billed.
CO-115 FAQ
Which modifiers apply when a procedure is stopped early?
Common options are 52 for reduced services, 53 for a procedure discontinued by the physician, and 73 and 74 for outpatient or ASC procedures discontinued before or after anesthesia. The right one depends on setting and payer rules.
Can I bill a patient for a canceled procedure?
Payers do not cover canceled services. Charging a patient a cancellation fee depends on your written financial policy and payer contracts; many contracts restrict it.
Does CO-115 mean I can rebill later?
Yes, once the procedure is performed, bill it with the actual date of service.