Skip to main content

CO-89 Denial Code: Professional Fees Removed

CO-89 means the payer removed professional fee charges from the claim, usually because a facility claim included physician or practitioner charges that must be billed separately on a professional claim. The removed amount is not paid on this claim.

Quick facts

Code
CO-89 (CARC 89)
Status
Active In use since January 1, 1995.
Code set
Claim Adjustment Reason Codes (CARC)
Group codes
  • CO (Contractual Obligation): The removed professional charges are not payable on this claim and are not the patient's responsibility. The professional service should be billed on its own claim by the practitioner or billing entity.
  • OA (Other Adjustment): Some payers report the removal as an other adjustment when it is purely a charge reclassification with no liability attached.
Official description
Professional fees removed from charges.
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What CO-89 means

CARC 89 reads simply: professional fees removed from charges. The payer found charges for a physician’s or practitioner’s professional work on a claim that, under its rules, should carry only facility or technical charges. It stripped those charges out and adjudicated the rest.

This most often happens on institutional claims (UB-04 or 837I). Hospitals and facilities bill for rooms, supplies, equipment, and staff, while the professional component is billed separately by the practitioner. If a professional fee revenue code or charge lands on the facility claim, the payer removes it and reports the amount as CARC 89.

Example: a hospital outpatient claim includes a professional fee line for the interpreting physician. The payer pays the facility lines and shows CO-89 for the professional line. The interpretation should be billed by the physician’s group on a professional claim.

Common causes

  • Professional fee revenue codes included on a facility claim when the payer requires split billing.
  • A charge description master (CDM) entry that attaches a professional charge to a facility service automatically.
  • Provider-based or hospital-owned clinics billing combined (global) charges where the payer expects separate facility and professional claims.
  • A professional charge billed on the facility claim and also on a professional claim, which leaves one of them to be removed.
  • Payer rules that changed from combined billing to split billing without the CDM being updated.

How to fix it

  1. Confirm which lines were removed. Match the CO-89 amount to specific revenue codes and charges on the claim.
  2. Check whether the professional service was billed separately. If the practitioner already submitted a professional claim, no further action is needed on the facility side beyond posting the adjustment.
  3. If it was not billed, have the practitioner or professional billing team submit it on a professional claim with the rendering NPI in box 24J and the correct place of service in box 24B.
  4. Post the CO-89 amount as a charge reclassification, not as bad debt and not to the patient.
  5. If you believe combined billing is allowed under your contract (some arrangements permit it), contact the payer with the contract language and request reprocessing.

How to prevent it

  • Review your CDM so professional fee charges do not auto-drop onto facility claims for payers that require split billing.
  • Keep a payer matrix showing which payers accept combined billing and which require separate facility and professional claims.
  • Reconcile facility and professional charges for the same encounter so each component is billed once, on the right claim.
  • Track CO-89 volume by department. A spike usually points to a CDM or charge-routing change, not a coding problem.

Specialty notes

Hospital-based radiology, pathology, and emergency departments see this most, because each has a clear facility component and a separately billed professional component. For the reverse situation, where technical charges are removed from a professional claim, see CO-134.

  • CO-134 (Technical fees removed from charges.): The mirror image: technical fees removed from charges, usually on a professional claim.
  • CO-97 (The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.): Payment for a service is included in another service's allowance, a bundling issue rather than a charge split.
  • CO-170 (Payment is denied when performed/billed by this type of provider.): Denial because the type of provider billing is not allowed to bill the service.
  • OA-18 (Exact duplicate claim/service (Use only with Group Code OA except where state workers' compensation regulations requires CO)): Duplicate claim, which can occur if both claims carry the same professional charge.

CO-89 FAQ

Is CO-89 a denial?

Not in the usual sense. The payer is separating professional charges out of a claim that should carry only facility or technical charges. The professional service can typically be paid when billed correctly on its own claim.

Who bills the professional fee after CO-89?

The practitioner or group that performed the professional component, on a professional claim (CMS-1500 or 837P), unless your arrangement with the payer allows a combined bill. Check the payer's billing rules for your facility type.

Can I bill the patient for the CO-89 amount?

No. Under CO the removed charge is not patient responsibility on this claim. Bill the professional service to the payer on the correct claim type.