CO-273 — Coverage guidelines exceeded
Claim-adjustment reason code 273 · typically reported as CO-273
What it means
The billing exceeds a limit in the payer’s coverage guidelines — quantity, duration, or replacement interval.
Why DME claims hit it
- Replacement equipment inside the reasonable-useful-lifetime window (typically 5 years)
- Supply quantities beyond policy maximums
How to fix it
- Track item lifetimes and resupply cadences; for legitimate early replacement (loss, irreparable damage, condition change), document and use the applicable modifier/narrative
Appeal posture
Appealable with documentation of the exception circumstances.
Related denial codes
CO-119 — Benefit maximum reachedCO-151 — Frequency / quantity not supportedCO-272 — Coverage / program guidelines not met
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