In 2025, healthcare providers continue to face common claim denials that impact revenue and workflow. Understanding these denial codes—and how to overcome them—is essential for maintaining financial health. Here are the top 5 denial codes this year and how to tackle them effectively:

1. CO-29: The Time Limit for Filing Has Expired
Many practices miss deadlines due to improper claim tracking. Solution: Automate your claim submission timelines using PMSLogix alerts and ensure documentation is ready in advance.

2. CO-50: Non-Covered Services
This denial often occurs when services are not deemed medically necessary. Solution: Verify payer policies before performing procedures and document clinical justification thoroughly.

3. CO-97: Procedure or Service Not Paid Separately
This denial results from billing services included in a bundled payment. Solution: Review bundling rules and use correct modifiers when appropriate.

4. CO-18: Duplicate Claim or Service
Duplicate claims waste time and money. Solution: Implement claim status checks and avoid resubmitting without verifying claim history.

5. CO-16: Claim Lacks Information
Missing or incomplete data triggers this common denial. Solution: Use PMSLogix’s validation tools to catch errors before submission and train staff on accurate data entry.

Final Thoughts
Reducing denials isn’t just about resubmission—it’s about prevention. With tools like PMSLogix, practices can automate checks, stay compliant, and protect their bottom line. Stay proactive and turn denial management into revenue success.