CO-171: Denied for Provider Type in Facility
Payment is denied when performed/billed by this type of provider in this type of facility. The combination of provider type and facility setting is not covered.
Why Claims Get Denied with CO-171
Denial code CO-171 is triggered when payment is denied when performed/billed by this type of provider in this type of facility. the combination of provider type and facility setting is not covered. Understanding the root causes helps prevent future denials and strengthens your appeal when one occurs.
Service performed in a facility type not authorized for the provider's specialty
Outpatient service billed from an inpatient setting or vice versa
Provider type not credentialed to bill from the specific facility type
Place of service code does not match the provider type restrictions
How to Appeal CO-171
Verify the place of service code is correct for where the service was actually performed. If the provider is authorized to perform the service in that facility type, provide credentialing and facility documentation. If the place of service code was incorrect, resubmit with the correct code.
Documentation Required for Appeal
A successful appeal of CO-171 requires thorough documentation. Gather these items before drafting your appeal letter:
Corrected place of service code (if applicable)
Provider credentialing for the facility type
Facility documentation showing the service location
Payer policy on provider type and facility restrictions
How to Prevent CO-171 Denials
Verify place of service codes match the actual service location. Understand payer restrictions on provider type and facility combinations. Ensure provider credentialing covers the facility type where services are rendered.
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