OB denials and how to overturn them
The short answer
Most OB denials trace to a handful of patterns: bundling edits against the global package (CO-97), missing 26/TC splits (CO-16), and medical-necessity gaps on detailed studies (CO-50). Each pattern has a documented fix.
Source: NCCISource: CMS
Denial CO-97: Bundled Into the Global OB Package The bundling denial, and the appeal that overturns it when the service was never global. CO-97 Denial CO-16: Claim Lacks Information The claim-defect denial: read the remark codes, fix the field, resubmit. CO-16 Denial CO-50: Medical Necessity on OB Services The necessity denial that is usually a diagnosis-linkage problem, not a clinical one. CO-50 OB Denial Appeal Letter Templates Fill-in-the-brackets appeal skeletons for CO-97, CO-50, and TC/26 denials. Templates