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CO-P7 Denial Code: Billed Code Not in P&C Fee Schedule

CO-P7 means the property and casualty payer's applicable fee schedule or fee database doesn't include the code you billed. The payer asks you to resubmit using the fee schedule code that best describes the service, with supporting documentation if required.

Quick facts

Code
CO-P7 (CARC P7)
Status
Active In use since November 1, 2013.
Code set
Claim Adjustment Reason Codes (CARC)
Group codes
  • CO (Contractual Obligation): The usual group. The provider must rebill with a recognized code; the claimant isn't billed for this line.
Official description
The applicable fee schedule/fee database does not contain the billed code. Please resubmit a bill with the appropriate fee schedule/fee database code(s) that best describe the service(s) provided and supporting documentation if required. To be used for Property and Casualty only.
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What CO-P7 means

CARC P7 says the applicable fee schedule or fee database does not contain the billed code. Please resubmit a bill with the appropriate fee schedule or fee database code(s) that best describe the service(s) provided and supporting documentation if required. X12 limits it to property and casualty claims. It replaced deactivated CARC 220.

Workers’ compensation and some auto no-fault systems price bills from a state fee schedule. Some carriers without a state schedule use a commercial fee database. If your code isn’t in the schedule or database the payer must use, it can’t price the line, so it asks you to rebill with a listed code.

The difference from CO-P18 matters: with P18, the payer finds a comparable listed service and pays it. With P7, the payer sends it back to you to recode.

Common causes

  • New national codes not yet adopted into the state fee schedule.
  • State-specific codes required for certain services, such as reports, forms, or evaluations.
  • Codes deleted from the state schedule.
  • Wrong fee schedule year used for the date of service.
  • Facility versus professional schedule mismatch.

How to fix it

  1. Identify the applicable fee schedule for the state, coverage line, and date of service.
  2. Find the listed code that best describes the service, including any state-specific codes.
  3. Use the schedule’s unlisted or by-report code if nothing fits, with a clear description.
  4. Attach documentation if the payer or state requires it for that code.
  5. Resubmit according to the carrier’s resubmission rules and state deadlines.

How to prevent it

  • Load state fee schedules into your billing system for the states where you treat P&C patients.
  • Review annual updates to each schedule and map new codes.
  • Flag P&C claims so coders check the state schedule before submission.
  • Track CO-P7 by state and code to spot mapping gaps. See how to read CARC and RARC codes.

Specialty notes

PT, chiropractic, and behavioral health providers treating workers’ comp patients often run into state-specific codes for evaluations, reports, and work conditioning that don’t match their usual health plan coding.

Remark codes that may appear with CO-P7

  • N631 (Medical Fee Schedule does not list this code.): The fee schedule doesn't list this code, though an allowance may be made for a comparable service.
  • N657 (This should be billed with the appropriate code for these services.): The service should be billed with the appropriate code.
  • N643 (The services billed are considered Not Covered or Non-Covered (NC) in the applicable state fee schedule.): The service is listed as not covered in the applicable state fee schedule.
  • CO-220Deactivated (The applicable fee schedule/fee database does not contain the billed code.): The deactivated code that CARC P7 replaced.
  • CO-P9 (No available or correlating CPT/HCPCS code to describe this service.): No CPT/HCPCS code exists to describe the service at all.
  • CO-P18 (Procedure is not listed in the jurisdiction fee schedule.): The code isn't in the jurisdiction fee schedule, but the payer paid a comparable service instead of asking for a rebill.
  • CO-181 (Procedure code was invalid on the date of service.): Procedure code invalid on the date of service, used outside P&C.

CO-P7 FAQ

Why would a valid code be missing from the fee schedule?

State workers' comp and auto fee schedules are updated on their own timelines and may lag behind national code updates, or deliberately exclude certain codes or use state-specific codes.

How do I fix CO-P7?

Look up the applicable fee schedule for the date of service, choose the listed code that best describes the service, and resubmit with any documentation the payer requires.

What if no listed code fits?

Some fee schedules have unlisted or by-report codes for services not otherwise described. Use those with a description and documentation, following the state's rules.

Does CO-P7 apply to health plans?

No. It's for property and casualty claims only, such as workers' comp and auto medical coverage.

Does resubmitting after CO-P7 restart the filing deadline?

Usually not. State rules and the carrier's policies decide how long you have to resubmit, so correct and resend the bill promptly.