CO13 denial code description and corrective action

• This denial occurs when the date of death (DOD) is earlier than the date of service (DOS).

• It is not practically possible in real life, and most often this denial occurs due to an error—either in entering the date of service (DOS) during billing or in the date of death (DOD) recorded on the insurance side.

• For example, if we submit a claim with a date of service (DOS) of 06/05/2024 while the insurance records show the date of death (DOD) as 06/04/2024, the claim will be denied because the DOD is earlier than the DOS.

Actions

• 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.

• Confirm the date of service (DOS) and date of death (DOD) by reviewing the patient’s medical records and supporting documents.

• Call the insurance company to verify the DOS and DOD as recorded on their end. If the DOS and DOD are the same, or if the DOS is earlier than the DOD, request the representative to reprocess the claim. Be sure to document the claim number, representative’s name, and call reference number, and then follow up on the claim after the turnaround time (TAT) provided.

• If the DOD precedes the DOS according to the insurance data, but our records confirm that the DOS is accurate, then we submit an appeal with the necessary documents to prove that the patient was alive on the mentioned DOS and that the provider rendered the services.

• For submitting an appeal, we must calculate the timely filing limit starting from the processed date. If the limit has been exceeded, the claim will be denied again for exceeding the filing deadline. In such cases, we should consult with the provider. Some clients may still want us to submit the appeal even after the timely filing limit has passed, so we should proceed according to their instructions.

• If the claim DOS was entered incorrectly by the biller, then we submit a corrected claim with the accurate DOS. In this case, we can either submit a new claim with the correct DOS or make a DOS correction and void the claim that was submitted with the wrong DOS.

• Medicare does not accept corrected claims, so in the case of any denial, a new claim must always be submitted.

Description