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CO-72 Denial Code (Deactivated): Coinsurance Day

CO-72 reported coinsurance days on an institutional stay, meaning days for which the patient owed a daily coinsurance. X12 deactivated it because the count is carried in the QTY segment with qualifier CD.

X12 deactivated CARC72 on October 16, 2003. Payers should no longer use it on new remittances, but it can still appear on older ERAs, corrected claims, and appeals.

Quick facts

Code
CO-72 (CARC 72)
Status
Deactivated StoppedOctober 16, 2003 (in use since January 1, 1995).
Code set
Claim Adjustment Reason Codes (CARC)
Group codes
  • CO (Contractual Obligation): Listed on inpatient remittances as a day-count item rather than a contractual reduction.
Official description
Coinsurance day. (Handled in QTY, QTY01=CD)
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What CO-72 meant

Long inpatient stays can move through benefit tiers. After the fully covered days, some plans, most notably Medicare Part A, require a per-day coinsurance for a further stretch of days. CARC 72 reported the number of those coinsurance days on the hospital’s remittance.

It was a count, not an explanation for a dollar amount, so it did not fit neatly into the adjustment segment.

What replaced it

No new reason code took its place. The official text says it is handled in QTY with qualifier CD, so the number of coinsurance days now appears as a supplemental claim quantity. The dollars the patient owes for those days are reported with PR-2. Related inpatient codes include CO-78 for non-covered days and CO-69 for day outliers.

If you still see CO-72

It should only exist in historical inpatient remittances. When reviewing that data, use the day count to double-check the coinsurance billed to the patient, and do not post the CO-72 line as a write-off. For current stays, read coinsurance days from the QTY segment and match them to your own day tracking.

  • PR-2 (Coinsurance Amount): Coinsurance amount, the active code for the dollars the patient owes.
  • CO-78 (Non-Covered days/Room charge adjustment.): Non-covered days or room charge adjustment.
  • CO-69 (Day outlier amount.): Day outlier amount.

CO-72 FAQ

What is a coinsurance day?

In inpatient benefits such as Medicare Part A, after a set number of fully covered days the patient owes a daily coinsurance for a further period. Each of those days is a coinsurance day.

Who owes the money associated with CO-72?

The daily coinsurance itself is patient responsibility. It is reported in dollars with CARC 2 and the PR group; CO-72 only conveyed how many such days there were.