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."

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 AbsentCO-50 · Not Medically NecessaryCO-16 · Missing or Invalid InformationCO-45 · Charge Exceeds Fee ScheduleCO-97 · Bundled into Another ServiceCO-29 · Timely Filing ExpiredCO-96 · Non-Covered ChargeOA-18 · Duplicate ClaimOA-22 · Coordination of BenefitsCO-11 · Diagnosis Inconsistent with ProcedureCO-151 · Too Many Services (Frequency/MUE)CO-B7 · Provider Not EligibleCO-27 · Coverage TerminatedCO-204 · Not Covered Under Current PlanCO-109 · Not Covered by This PayerCO-119 · Benefit Maximum ReachedCO-4 · Modifier Inconsistent or MissingCO-15 · Authorization Number Missing or InvalidOA-23 · Prior Payer Adjudication ImpactCO-24 · Charges Covered Under CapitationCO-26 · Expenses Incurred Prior to CoverageCO-54 · Assistant Surgeon Not CoveredCO-55 · Experimental / InvestigationalCO-59 · Multiple/Concurrent Procedure ReductionCO-107 · Related/Qualifying Claim Not IdentifiedCO-167 · Diagnosis Not CoveredCO-170 · Denied for This Provider TypeCO-181 · Procedure Code Invalid on Date of ServiceCO-182 · Procedure Modifier Invalid on Date of ServiceCO-183 · Referring Provider Not Eligible to ReferCO-185 · Rendering Provider Not EligibleCO-198 · Precertification / Authorization ExceededCO-226 · Requested Provider Information Not ProvidedCO-231 · Mutually Exclusive ProceduresCO-234 · Procedure Not Paid SeparatelyCO-236 · Procedure/Modifier Combination Not CompatibleCO-242 · Out-of-Network / Non-Network ProviderCO-252 · Documentation Required to AdjudicateCO-253 · Sequestration ReductionCO-256 · Not Payable Per Managed-Care ContractCO-288 · Referral AbsentCO-B15 · Qualifying Service Not ReceivedCO-B16 · New Patient Qualifications Not MetCO-A1 · Claim/Service Denied (Remark Required)

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