CO129 denial code description and corrective action

Prior processing information appears incorrect.

This denial is mostly received from secondary or consecutive payers and occurs for two reasons.
1. Primary insurance did not pay the claim.
2. Primary insurance paid the claim, but the payment information submitted on the claim form to the secondary insurance is incorrect.

First, we need to verify the status of the claim. This can be done by checking the status through the insurance web portal or by calling the payer.
The most important step is to determine whether the claim denial is valid or if the insurance has denied the claim by mistake.
Call the insurance company to verify the denial. If the primary has paid the claim and the payment information (Box #29 on the CMS-1500 form and Box #54 on the UB-04 form) is found to be correct, request the representative to reprocess the claim. Be sure to document the claim number, representative’s name, and call reference number, and follow up on the claim after the provided turnaround time (TAT).
If the primary has paid the claim and the information on the claim form submitted to the secondary is incorrect, correct the information and rebill the claim. Also, review the payment information on the new claim, and if it still appears incorrect, mail or fax the claim to the insurance.
If the primary did not pay the claim and it was billed to the secondary, resulting in this denial, then the next step is to work on resolving the primary denial.
Only a few primary denials such as non-covered services under the patient’s plan, maximum benefits reached, and other PR (Patient Responsibility) denials may be considered for payment by the secondary, depending on the member’s plan type.