Medicaid Denial CO-9

For providers that have received the denial code CO-9 on Medicaid claims, this means that the ICD9 code used to bill is inconsistent with the patient's age.

This may mean:

• The diagnosis code is incorrect
• The child's date of birth is incorrect in NYEIS or KIDS
• The child's date of birth is incorrect in eMedNY
• The child's CIN is incorrect in NYEIS or KIDS

If the diagnosis code used is incorrect, providers should use the Medicaid Claims Needing Attention page to correct the ICD9 code on the claim.  This Knowledge Base article has more information about that page.  Providers may also find the ICD9 code reference list, available under "Reports" in the EIBilling.com menu helpful.

Some claims billed with an ICD9 code for low birth weight receive this denial, as the diagnosis is no longer consistent with the patient's age.  In that case, the provider should edit the claim to use an ICD9 code that is appropriate for the patient's age.  Providers should contact the BEI for further advice on which ICD9 code to use in this case.  The BEI can be contacted by phone at (518)473-7016 or by email at bei@health.state.ny.us.

If the child's date of birth or CIN is incorrect in NYEIS or KIDS, the provider will need to contact the municipality or county to have them work with the child's service coordinator to correct that information.  Once the information is corrected, that change will be reflected on EIBilling.com after the next weekly NYEIS data import or after the county uploads a KIDS insurance batch.

If the child's date of birth is incorrect in eMedNY, the provider will need to contact the municipality or county, who will need to work with the child's service coordinator and the local DSS to have that information corrected in eMedNY.  Once the information is corrected, that change will be reflected on EIBilling.com after we receive that data from eMedNY.

For discrepancies in date of birth or CIN, once that information is listed correctly on EIBilling.com, providers can use the Medicaid Claims Needing Attention page to resubmit the claims.