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CO-D13 Denial Code (Deactivated): Financial Interest

CO-D13 meant the claim was denied because the service was performed by a facility or supplier in which the ordering or referring physician had a financial interest. X12 deactivated it and pointed to CARC 17, since retired; related situations now use CARC 213 or remark M134.

X12 deactivated CARCD13 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.

Code: CO-D13 (CARC D13)
Status: Deactivated StoppedOctober 16, 2003 (in use since January 1, 1995).
Code set: Claim Adjustment Reason Codes (CARC)
Group codes: CO (Contractual Obligation): The facility or supplier bore the denial; it was not a patient balance.
Official description: Claim/service denied. Performed by a facility/supplier in which the ordering/referring physician has a financial interest.
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What CO-D13 meant

CARC D13 concerned self-referral. The payer found that the physician who ordered or referred the service had a financial interest in the facility or supplier that performed it, and denied the claim on that basis. Unlike its neighbors in the D-series, this was not just about a missing field.

What replaced it

X12’s note points to code 17, discussed on the CO-17 page, which has also been retired. For denials based on self-referral rules, the active code is CO-213, non-compliance with physician self-referral prohibition legislation or payer policy. Remark code M134 can identify that the performing entity is one in which the provider has a financial interest.

If you still see CO-D13

It will only be in older claim data. A comparable denial today should go to your compliance team rather than being handled as a routine rebill. They can determine whether the relationship qualifies for an exception and what documentation the payer would need. Do not bill the patient for a service denied on this basis without that review.

CO-17Deactivated (Requested information was not provided or was insufficient/incomplete.): The replacement named at the time, since deactivated.
CO-213 (Non-compliance with the physician self referral prohibition legislation or payer policy.): Non-compliance with physician self-referral prohibition legislation or payer policy.
M134 (Performed by a facility/supplier in which the provider has a financial interest.): Remark code: performed by a facility or supplier in which the provider has a financial interest.

CO-D13 FAQ

Why would a financial interest cause a denial?

Federal and some state self-referral rules restrict physicians from referring patients to entities in which they have a financial relationship, unless an exception applies. Claims for referred services can be denied when the rules are not met.

Can a CO-D13 denial be corrected like a paperwork error?

Only if the financial relationship falls within an exception and the payer needs documentation of that. Whether an exception applies is a compliance and legal question, not a billing fix.

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