Why does my claim say CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement) even though the claim paid?
When you have a paid claim and there is an ANSI denial reason C0-45, it generally means that your submitted amount was higher than the Medicare allowable for the item you billed. Medicare will only reimburse at the appropriate fee schedule amount. Current and past fee schedule amounts can be obtained by going to the DME MAC Jurisdiction C web page (www.cignagovernmentservices.com/jc) and clicking on Fee Schedules in the Coverage and Pricing section.
