CO51 denial code description and corrective action

Non covered services because this is a pre-existing condition.

If a person wants to purchase a new insurance policy while already suffering from a disease, the insurance may refuse to cover services related to that condition. This existing disease is considered a pre-existing condition.
Some plans may provide coverage, but they often come with higher premiums and may include a waiting period.
A waiting period means that the insurance will cover these services only after a specified time, such as six months from the policy’s effective date. If a service is billed within the waiting period, it will be denied with this denial code.

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.
Call the insurance company to confirm whether the service is not covered or denied because the date of service falls within the waiting period.
If the service is covered and the date of service falls after the waiting period, request the representative to reprocess the claim. Be sure to note the claim number, representative’s name, and call reference number, and follow up on the claim after the provided turnaround time (TAT).
If the service is not covered or the date of service falls within the waiting period, it becomes the patient’s responsibility. In this scenario, bill the claim to the patient, as the secondary insurance will not pay.
If there is any other active primary insurance, bill the claim to that insurance before releasing it to the member.