DENIAL CODE · CO-58

CO-58: Inappropriate Place of Service

CO-58 means the payer says the service was billed with a place-of-service that doesn't match what it will pay for that procedure — often an office-vs-facility or site-of-care dispute.

Official (X12/WPC): "Treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service."
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Why payers issue CO-58

  • The POS code on the claim was wrong or mismatched to the procedure
  • The payer's policy requires the service at a different site of care
  • A site-of-service medical policy (e.g. infusions, imaging) steered it elsewhere
  • The facility/professional split was billed with the wrong POS

Is it recoverable? Recoverable when the POS was miscoded or the site was medically appropriate — correct the POS or document why the site of care was necessary.

Common questions

What does CO-58 mean?

CO-58 means the payer says the service was billed with a place-of-service that doesn't match what it will pay for that procedure — often an office-vs-facility or site-of-care dispute. Treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service.

How do I appeal or fix a CO-58 denial?

Recoverable when the POS was miscoded or the site was medically appropriate — correct the POS or document why the site of care was necessary. Common causes: the POS code on the claim was wrong or mismatched to the procedure; the payer's policy requires the service at a different site of care; a site-of-service medical policy (e.g. infusions, imaging) steered it elsewhere; the facility/professional split was billed with the wrong POS.

Is a CO-58 denial worth appealing?

Recoverable when the POS was miscoded or the site was medically appropriate — correct the POS or document why the site of care was necessary. You only pay on what's actually recovered, so there's no cost to working the ones that are winnable.

Other denial codes
CO-197 · Precertification / Authorization Absent →CO-50 · Not Medically Necessary →CO-16 · Missing or Invalid Information →CO-45 · Charge Exceeds Fee Schedule →CO-97 · Bundled into Another Service →CO-29 · Timely Filing Expired →CO-96 · Non-Covered Charge →OA-18 · Duplicate Claim →OA-22 · Coordination of Benefits →CO-11 · Diagnosis Inconsistent with Procedure →CO-151 · Too Many Services (Frequency/MUE) →CO-B7 · Provider Not Eligible →CO-27 · Coverage Terminated →CO-204 · Not Covered Under Current Plan →CO-109 · Not Covered by This Payer →CO-119 · Benefit Maximum Reached →CO-4 · Modifier Inconsistent or Missing →CO-15 · Authorization Number Missing or Invalid →OA-23 · Prior Payer Adjudication Impact →CO-24 · Charges Covered Under Capitation →CO-26 · Expenses Incurred Prior to Coverage →CO-54 · Assistant Surgeon Not Covered →CO-55 · Experimental / Investigational →CO-59 · Multiple/Concurrent Procedure Reduction →CO-107 · Related/Qualifying Claim Not Identified →CO-167 · Diagnosis Not Covered →CO-170 · Denied for This Provider Type →CO-181 · Procedure Code Invalid on Date of Service →CO-182 · Procedure Modifier Invalid on Date of Service →CO-183 · Referring Provider Not Eligible to Refer →CO-185 · Rendering Provider Not Eligible →CO-198 · Precertification / Authorization Exceeded →CO-226 · Requested Provider Information Not Provided →CO-231 · Mutually Exclusive Procedures →CO-234 · Procedure Not Paid Separately →CO-236 · Procedure/Modifier Combination Not Compatible →CO-242 · Out-of-Network / Non-Network Provider →CO-252 · Documentation Required to Adjudicate →CO-253 · Sequestration Reduction →CO-256 · Not Payable Per Managed-Care Contract →CO-288 · Referral Absent →CO-B15 · Qualifying Service Not Received →CO-B16 · New Patient Qualifications Not Met →CO-A1 · Claim/Service Denied (Remark Required) →

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