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CO-283 Denial Code: Attending Provider Not Eligible

CO-283 means the payer determined the attending provider listed on the claim isn't eligible to provide direction of care, for example because of provider type, enrollment status, or program rules. It mainly affects institutional claims that report an attending provider.

Quick facts

Code
CO-283 (CARC 283)
Status
Active In use since November 1, 2017.
Code set
Claim Adjustment Reason Codes (CARC)
Group codes
  • CO (Contractual Obligation): The usual group. The facility or provider must correct the attending information or enrollment; the patient isn't billed.
Official description
Attending provider is not eligible to provide direction of care.
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What CO-283 means

CARC 283 says the attending provider is not eligible to provide direction of care. Institutional claims identify an attending provider: the clinician primarily responsible for the patient’s care during the stay or episode. Payers check that this provider is allowed, under their enrollment and program rules, to fill that role. If not, the claim is denied with CO-283.

The issue isn’t whether services were performed, but whether the person listed as directing care qualifies. That can depend on provider type, enrollment status, specialty, or program-specific rules. Some programs require a physician or a specific practitioner type to direct care, while others allow certain non-physician practitioners.

Common causes

  • Attending provider not enrolled with the payer, or enrollment inactive on the date of service.
  • Provider type not allowed to direct care under the program, such as a practitioner type the program doesn’t recognize as attending.
  • Wrong NPI or name in the attending provider fields.
  • Excluded or sanctioned provider listed as attending.
  • Resident or unlicensed provider listed instead of the supervising attending physician.
  • Hospice or home health attending designation not matching the patient’s election or plan of care.

How to fix it

  1. Check the remark codes for data issues (N253, N251).
  2. Confirm who directed care from the medical record.
  3. Verify enrollment and eligibility for that provider with the payer on the dates of service.
  4. Correct the attending provider name, NPI, and taxonomy on the claim.
  5. Submit a replacement claim using the payer’s frequency code rules.
  6. Complete enrollment if the attending isn’t enrolled, then request reprocessing where the payer allows retroactive enrollment.

How to prevent it

  • Keep a roster of eligible attending providers by payer and program.
  • Check enrollment before a provider starts serving as attending.
  • Map attending data from the medical record rather than defaulting to a facility or department head.
  • Monitor exclusion lists for all providers. See provider enrollment denials.

Specialty notes

Hospice, home health, skilled nursing, and psychiatric facilities are most likely to see CO-283 because their programs define who can direct or certify care. Teaching hospitals should list the supervising attending physician, not a resident.

Remark codes that may appear with CO-283

  • N253 (Missing/incomplete/invalid attending provider primary identifier.): The attending provider's primary identifier (NPI) is missing, incomplete, or invalid.
  • N251 (Missing/incomplete/invalid attending provider taxonomy.): The attending provider's taxonomy is missing or invalid.
  • N90 (Covered only when performed by the attending physician.): Covered only when performed by the attending physician.
  • CO-185 (The rendering provider is not eligible to perform the service billed.): The rendering provider isn't eligible to perform the service, a similar check on a different role.
  • CO-183 (The referring provider is not eligible to refer the service billed.): The referring provider isn't eligible to refer the service.
  • CO-184 (The prescribing/ordering provider is not eligible to prescribe/order the service billed.): The prescribing or ordering provider isn't eligible.
  • CO-B7 (This provider was not certified/eligible to be paid for this procedure/service on this date of service.): The provider wasn't certified or eligible on the date of service.

CO-283 FAQ

What is an attending provider?

On institutional claims, the attending provider is the clinician primarily responsible for the patient's care during the stay or episode, reported in the attending provider fields of the UB-04 or 837I.

Why would an attending provider be ineligible?

The provider may not be enrolled with the payer, may be the wrong provider type for the program (for example, some programs require a physician to direct care), may be excluded or sanctioned, or may have an NPI mismatch on the claim.

How do I fix CO-283?

Confirm who actually directed the care, check that provider's enrollment and eligibility with the payer, and correct the attending provider information. Submit a replacement claim once the data or enrollment is fixed.

Does this apply to hospice and home health?

It can. Programs such as hospice and home health have specific rules for who may serve as attending or certifying provider. Check the program's requirements.