CO-115: Procedure Postponed, Canceled, or Delayed
The payer says this procedure was not completed. If it was actually performed, appeal with operative notes and procedure reports. If it was genuinely postponed or canceled, void the claim and rebill when the procedure is done.
What Does CO-115 Mean?
CO-115 is a contractual adjustment indicating the payer determined the procedure was postponed, canceled, or not completed as billed. The provider must either prove the service was furnished or absorb the denial. If the procedure was genuinely not performed, the claim should be voided — this is not a write-off for a legitimate service, it is a correction for a claim that should not have been submitted.
CARC 115 fires when a payer identifies that a billed procedure was postponed, canceled, or not completed on the date of service indicated on the claim. This denial says the payer has information or reason to believe the service was not fully rendered — the claim was submitted for a procedure that did not happen as billed.
The most common scenario is a billing workflow failure: a procedure was scheduled and the claim was auto-generated, but the procedure was subsequently postponed or canceled due to patient health changes, equipment failures, scheduling conflicts, or insurance authorization issues. The billing system released the claim before anyone flagged the cancellation. Less commonly, the payer may have external information (such as a facility report or another claim) indicating the procedure was not completed.
This denial can also occur when a procedure was partially completed before being stopped. In those cases, the full procedure code should not be billed — instead, any separately billable preparatory work (anesthesia, pre-procedure prep) should be billed under appropriate codes. CO is the primary group code because billing for an uncompleted procedure is a provider-side issue. The fix depends on whether the procedure was actually completed: if yes, appeal with proof; if no, void the claim.
Common Causes
| Cause | Frequency |
|---|---|
| Procedure billed but not completed The provider submitted a claim for a procedure that was scheduled but ultimately postponed, canceled, or not completed — the service date on the claim corresponds to a canceled or rescheduled appointment rather than a completed procedure | Most Common |
| Patient health condition prevented completion The patient's medical condition changed or deteriorated before or during the procedure, requiring postponement or cancellation for safety reasons, but the billing system generated a claim for the originally scheduled service | Common |
| Administrative or scheduling errors Scheduling mistakes, documentation errors, or miscommunication between clinical and billing departments resulted in a claim being submitted for a procedure that was not performed on the billed date | Common |
| Facility or equipment issues Equipment failure, facility emergencies, power outages, or natural disasters forced the procedure to be postponed, but the claim was submitted as if the service was completed | Occasional |
| Authorization or insurance issues discovered mid-process Prior authorization was denied, coverage issues were discovered after the patient was prepped, or referral requirements were not met, causing the procedure to be halted after some preparatory work was done | Occasional |
| Patient non-compliance with pre-procedure instructions The patient did not follow required pre-procedure instructions (such as fasting requirements, medication holds, or pre-procedure testing), making it unsafe to proceed and requiring postponement | Occasional |
How to Resolve
Determine whether the procedure was actually completed, then either appeal with proof of completion or void the claim and rebill when the procedure is performed.
- Confirm procedure status Check the medical record, operative notes, and scheduling system to determine whether the procedure was completed, partially completed, or not performed.
- Appeal if completed If the procedure was performed, compile operative notes, procedure reports, anesthesia records, and post-procedure documentation. Submit an appeal with clear evidence the service was furnished on the billed date.
- Bill separately billable components If the procedure was partially completed, identify any preparatory services that were performed and can be billed under appropriate codes (e.g., anesthesia, pre-procedure evaluation).
- Void if not completed If the procedure was genuinely not performed, void the claim. Do not let it remain in accounts receivable as a pending item.
- Rebill after completion When the rescheduled procedure is completed, submit a new claim with the correct date of service and full documentation.
Appeal CO-115 only when the procedure was actually completed and the payer incorrectly categorized it as postponed, canceled, or delayed. Include operative notes, procedure completion reports, anesthesia records, and post-procedure documentation proving the service was furnished on the billed date of service. Do not appeal if the procedure was genuinely not completed.
Common RARC Pairings
The RARC code tells you exactly what triggered the CO-115:
| RARC | Description |
|---|---|
| N432 | Procedure postponed, canceled, or rescheduled Confirm whether the procedure was completed; if so, appeal with documentation. If not, void the claim and rebill when completed → |
| N30 | Patient not eligible for this service on this date Verify patient eligibility and whether the service was rescheduled to a different date → |
How to Prevent CO-115
- Implement billing system controls that prevent claims from being generated for procedures until completion is confirmed
- Establish communication protocols between scheduling, clinical, and billing departments so cancellations are immediately reflected in the billing queue
- Verify authorization status and patient readiness before procedure day to reduce last-minute cancellations
- Train billing staff to verify procedure completion status before releasing claims for surgical and high-value procedures
- Optimize scheduling systems to track procedure status (completed, postponed, canceled) in real-time
- Educate patients on pre-procedure requirements well in advance to reduce cancellations due to non-compliance with prep instructions
General Prevention
- Implement billing system controls that prevent claims from being generated for canceled, postponed, or rescheduled procedures until the service is confirmed complete
- Establish clear communication protocols between scheduling, clinical, and billing departments so that cancellations and postponements are immediately reflected in the billing queue
- Verify prior authorization status and patient readiness before the procedure date to reduce last-minute cancellations
- Train billing staff to review procedure completion status before releasing claims, particularly for surgical and high-value procedures
- Optimize scheduling systems to track procedure status (completed, postponed, canceled) and prevent billing for incomplete services
Also Filed As
The same CARC 115 may appear with different Group Codes:
Related Denial Codes
Sources
- https://www.mdclarity.com/denial-code/115
- https://droidal.com/blog/medical-billing-denial-codes/
- https://practiceperfectss.com/list-of-denial-codes-in-medical-billing/
- Codes maintained by X12. Visit x12.org for official definitions.