Denial codes · Denial code

CO-170 on a dietitian's claim: the payer won't pay this code to an RD

The short answerCO-170 means the payer does not pay this service when it is performed or billed by your type of provider. For dietitians it usually means a code outside what the plan pays RDs for (E/M codes, 99401-99404, G0447 under the RD's own NPI), or a claim where the provider type the payer sees (taxonomy, specialty, enrollment) is not the one it credentialed for MNT. Recode to MNT if that is what you did, fix the taxonomy or NPI if that was the cause, and appeal only when the plan's own policy says RDs can bill it.
Official descriptionPayment is denied when performed/billed by this type of provider.
Group codeCO: do not bill the patient
Common remark codesN95 (provider type may not bill this service), N570
RD taxonomy133V00000X (Dietitian, Registered) or a 133V subspecialty
Medicare specialty code71, dietitians/nutritionists
Fix routeCorrected claim (recode or taxonomy); appeal only with policy support

CO-170 is a denial about who billed, not what happened. The payer is fine with the patient's coverage and has no complaint about the visit; it simply does not pay that service when your kind of provider performs or bills it. For registered dietitians, that almost always means one of two things: a code outside what the plan pays RDs for, or a claim where the payer sees you as a different kind of provider than the one it credentialed.

What CO-170 means (official X12 wording)

The X12 Claim Adjustment Reason Code list defines CARC 170 as:

"Payment is denied when performed/billed by this type of provider."

Like several newer CARCs, its usage note points to the 835's Healthcare Policy Identification segment (loop 2110 REF), where the payer can name the policy. Its neighbor, CARC 171, adds "in this type of facility" for setting-specific restrictions.

The remark code most often paired with it is N95: "This provider type/provider specialty may not bill this service." You may also see N570, "Missing/incomplete/invalid credentialing data," when the problem is how you are enrolled rather than the code itself.

The usual causes on dietitian claims

1. Codes that plans don't pay RDs for

2. The payer sees the wrong provider type

3. Medicaid programs that do not recognize RDs as billing providers

Some state Medicaid programs and Medicaid managed care plans pay nutrition services only when billed by certain provider types, or only in certain settings. The program's provider manual is the only reliable answer; check it before you see the patient. Our pages on Medicaid nutrition counseling collect published examples.

4. Services billed under the RD that belong under someone else

The reverse happens too: a clinic bills an RD's MNT visit under the supervising physician's NPI, or a hospital outpatient department bills without the RD having reassigned benefits to it. CMS notes that hospitals can bill MNT only if the dietitian reassigns benefits; otherwise the RD bills under their own number.

How to fix a CO-170

  1. Identify the policy. Read the remark code and the policy reference; if missing, call and ask which provider types can bill the code.
  2. Recode if the visit was MNT. If what you documented was medical nutrition therapy, send a corrected claim (frequency code 7 with the original claim number) using 97802 or 97803 and the right units. Do not recode to something the note does not support.
  3. Fix enrollment data if that was the cause. Correct the taxonomy on the claim and in NPPES, confirm the payer's credentialing file lists you as an RD with the right specialty, then send a corrected claim.
  4. If the service belongs to another provider (for example incident-to under a physician), bill it correctly under that provider's rules. Incident-to has strict requirements; read Can dietitians bill incident-to? first.
  5. Appeal only with policy support. If the plan's published policy or your contract says RDs can bill the code, appeal with that page attached.

How to prevent CO-170

If the payer says you, specifically, were not eligible on that date (a credentialing effective date issue rather than a provider-type rule), the code is usually CO-B7. For every other code, see the denial code lookup.

Sources

  1. X12 — Claim Adjustment Reason Codes (CARC 170)
  2. X12 — Remittance Advice Remark Codes (N95, N570)
  3. CMS — Medicare Claims Processing Manual, Ch. 4 §300.3–300.5 (MNT providers, specialty code 71)
  4. UnitedHealthcare — Nonphysician Health Care Professionals Billing E/M Codes Policy
  5. NUCC — Health Care Provider Taxonomy code set

Sources checked . Payer rules change; verify the member's benefits.

Frequently asked questions

What does CO-170 mean for a dietitian?

The payer will not pay the billed service when your provider type performs or bills it. It is not saying the patient lacks coverage or that the visit was unnecessary; it is saying RDs (or your enrolled specialty) are not an allowed billing provider for that code under its policy.

Can a registered dietitian bill E/M codes like 99213?

Generally no. E/M codes are billed by physicians and certain other practitioners; Medicare pays RDs for MNT (97802, 97803, 97804, G0270, G0271), not E/M. Commercial policies vary, but most expect MNT codes from RDs. UnitedHealthcare's nonphysician E/M policy says RDs should not report 99401 and should use MNT codes.

Can a dietitian bill G0447 for obesity counseling?

Not under their own NPI for Medicare. G0447 must be billed by a primary care practitioner in a primary care setting. An RD can deliver it incident-to a primary care practitioner who bills it, if the incident-to rules are met.

Could my taxonomy code cause CO-170?

Yes. If the claim or your NPPES record carries a taxonomy the payer does not associate with MNT, or the billing NPI is enrolled under a different specialty, the payer may see the wrong provider type. RDs typically use 133V00000X (Dietitian, Registered) or a 133V subspecialty.

Can I bill the patient for a CO-170?

No. The CO group code means the amount is your contractual obligation. Recode or correct the claim if you can; otherwise it is a write-off.

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