CO-45 — Charge exceeds the fee schedule / allowed amount
Claim-adjustment reason code 45 · typically reported as CO-45 or PR-45
What it means
The contractual write-down: difference between your billed charge and the payer’s allowable. Expected on essentially every paid claim.
Why DME claims hit it
- Billed charges set above the Medicare DMEPOS fee schedule (normal practice)
How to fix it
- Post as contractual adjustment; monitor that allowables match the current fee schedule — underpayments hide here
Appeal posture
Only if the payer’s allowable is below the contracted/fee-schedule rate — then dispute with the fee schedule cited.
Related denial codes
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